Judgment — ECLI:EU:C:2004:630
Date: 2004-10-14
Language of the case: German
Court formation: Sixth Chamber
Based on: Treaty establishing the European Economic Community (1957)
Subject matter: Social security for migrant workers
Concepts: Stay or residence outside the competent Member State
Procedure: Reference for a preliminary ruling
Origin: Germany

Summary of the Judgment Social security for migrant workers – Health insurance – Reimbursement by the competent Member State of medical expenses incurred in another Member State – Application of the rates in effect in the Member State of residence – Article 34 of Regulation No 574/72 – Practice of a health insurance fund whereby medical expenses not exceeding a certain amount are reimbursed in full – Whether permissible (Council Regulation No 574/72, Art. 34) In the absence of completion of the formalities giving entitlement, during a stay in a Member State other than the competent State, to receive the benefits in kind provided by the institution of the place of stay on behalf of the competent institution, Article 34 of Regulation No 574/72 enables persons covered by social insurance to obtain from the competent State reimbursement of expenses incurred during that stay at the rates administered by the institution of the place of stay. That provision is to be interpreted as not precluding a practice whereby a health insurance fund, in the application of national rules, reimburses medical costs incurred by its members during a stay in another Member State in full when those costs do not exceed a certain amount. The fact that that reimbursement is in full suffices to ensure that the reimbursement received by the person covered by social insurance is at least equivalent to, if not higher than, what that person would have received had reimbursement been made in the circumstances provided for in that provision. (see paras 24, 27, operative part)