In the Balkans, the card is valid only in EU member countries—Croatia, Greece, Bulgaria, Romania, and Slovenia. In other parts of the region, including Serbia, Bosnia and Herzegovina, Montenegro, Albania, North Macedonia, and Kosovo, the card is not accepted. These countries are not part of the EHIC system, meaning that patients must cover the costs themselves or rely on private insurance.
Slovenian insured individuals are in a slightly different position. Slovenia maintains bilateral healthcare agreements with most former Yugoslav republics. This means that, with the appropriate certificate from the Slovenian Health Insurance Institute, Slovenians can access urgent medical services in non-EU countries such as Serbia, Bosnia and Herzegovina, and North Macedonia. It is essential to obtain this certificate before traveling, as the EHIC alone is not sufficient in these cases.
Some other European countries used to have similar agreements, but most no longer use them. Austria, Hungary, and Croatia still maintain special arrangements with some countries in the region, but these usually apply only to pensioners or specific groups—not to regular tourists. Germany, which cooperated closely with Yugoslavia in the past through labour migration programs, no longer recognises such coverage, except in very limited and specific circumstances.
Even in countries where the EHIC is valid, the card does not cover everything. It does not apply to private healthcare services, does not reimburse transportation costs back home, does not cover out-of-pocket expenses, and does not allow access to non-urgent care. Patients are still responsible for co-payments, medications, and certain medical procedures. For transport home in the event of illness or injury, additional insurance is required. Likewise, the EHIC does not cover medical issues arising during long-term stays or employment abroad.
Travellers heading outside the EU or wishing to avoid unexpected costs are strongly advised to obtain additional travel health insurance. The European Health Insurance Card is not a substitute for comprehensive health coverage—it provides only a basic level of protection within the public healthcare systems of participating countries.
