2003/752/EC: Decision No 190 of 18 June 2003 concerning the technical specifications of the European health insurance card (Text with relevance for the EEA and for the EU/Switzerland Agreement.)
Date: 2003-06-18
Institutions: Administrative Commission on Social Security for Migrant Workers, European Commission
Subjects: EU Member State, health card, health insurance, technical specification

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DECISION No 190

of 18 June 2003

concerning the technical specifications of the European health insurance card

(Text with relevance for the EEA and for the EU/Switzerland Agreement)

(2003/752/EC)

THE ADMINISTRATIVE COMMISSION,

Having regard to Administrative Commission Decision No 189 of 18 June 2003 aimed at introducing a
European health insurance card to replace the forms necessary for the application of Council Regulations
(EEC) No 1408/71 and (EEC) No 574/72 as regards access to health care during a temporary stay in a
Member State other than the competent State or the State of residence,

Whereas:

(1)

(2)

The European health insurance card will be issued by the institution of the competent State or the
State of residence. In order to facilitate the acceptance and reimbursement of the cost of treatment
on the basis of the European card, it will be necessary for the three main parties concerned, namely
the insured persons, the care providers and the institutions, to recognise easily and accept the
European card in conformity with a single model and uniform specifications.

The information which must be visible on the European card is defined in Article 6 of
Administrative Commission Decision No 189. The introduction of the European card with visible
data is the first stage of a process leading ultimately to the abolition of the current paper forms and
the use of an electronic medium providing entitlement to health care during a temporary stay in a
Member State other than the competent State or the State of residence. Consequently, the
competent institutions of the Member States wishing to do so may also incorporate on an electronic
medium, such as a microchip or magnetic strip, from the initial stage onwards, the data referred to
in this recital.

(3) When exceptional circumstances prevent the person concerned from producing the European card,
a provisional replacement certificate in accordance with a uniform model must be made out,

HAS DECIDED AS FOLLOWS:

Article 1

The design and specifications of the European health insurance card shall be established in accordance
with Annex 1 to this Decision.

Article 2

The model of the provisional replacement certificate shall be established in accordance with Annex 2 to
this Decision.

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This Decision shall be published in the Official Journal of the European Union. It shall be applicable from
the first day of the month following its publication.

Article 3

The Chairman of the Administrative Commission

Theodora TSOTSOROU

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ANNEX 1

TECHNICAL PROVISIONS CONCERNING THE DESIGN OF THE EUROPEAN HEALTH INSURANCE CARD

1.

Introduction

In compliance with the related decisions of the Administrative Commission for Social Security for Migrant Workers, the European
health insurance card provides a minimum set of ‘eye-readable’ data to be used in a Member State other than the Member State of
insurance or residence for:

— identifying the insured person, the competent institution and the card,

— stating the entitlement to receive care during a temporary stay in another Member State.

The models shown below are based on the technical specifications defined in this document but are to be considered for illustration
purposes only.

Figure 1: Example for the front side

Figure 2: Example for the reverse side

While the ordering of the eye-readable data is identical in both models, i.e. irrespective of the side used by the European health insurance
card, a different structure has been defined for the front and the reverse side. This is the result of a compromise between the required
unique model for the European card and the structural differences of both sides while retaining the overall style between the front and
the back of the card.

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2.

Normative reference

Reference

Document title/description

Issuing date

ISO 3166-1

Codes for the representation of names of countries and their subdivisions — Part 1: Country
codes

ISO/IEC 7810

Identification cards — Physical characteristics

ISO/IEC 7816

Identification cards — Integrated circuit(s) cards with contacts

Part 1:

Physical characteristics

Part 2:

Dimension and location of the contacts

ISO 8859-1

8-bit single-byte coded graphic character sets

Part 1:

Latin alphabet No 1

1997

1995

1998

1999

1998

EN 1867

Machine readable cards — Health care application — Numbering system and registration
procedure for issuer identifiers

1997

3.

Specifications

3.1.

Definitions

The front side is the side on which the microprocessor (if any) is embedded. The reverse side is the side on which the magnetic stripe (if
any) is attached. If there is neither a microprocessor nor a magnetic stripe, the front side of the card will be the side on which the
information outlined in this document is presented.

3.2.

Overall structure

The format of the European health insurance card complies with the ID-1 format (53,98 mm high, 85,60 mm wide and 0,76 mm
thick). However, if the European health insurance card takes the form of a sticker to be applied on the reverse side of a national card,
the ID-1 thickness criterion will not apply.

3.2.1.

E u r o p e a n h e a l t h i n s u r a n c e c a r d : f r o n t s i d e o f t h e c a r d

The background is divided into two parts by an axis vertically splitting the card area into part 1 on the left (53 mm wide) and part 2 on
the right.

Four placeholders are positioned thanks to a set of guiding lines:

— three vertical guiding lines

(a)

at 5 mm from the left edge of the card,

(b)

at 21,5 mm from the left edge of the card,

(c)

at 1 mm from the right edge of the card,

— three horizontal guiding lines

(d)

at 2 mm from the top edge of the card,

(e)

at 17 from the top edge of the card,

(f)

at 5 mm from the bottom edge of the card.

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(a)

Card without chip

(b)

Chip card

3.2.2.

E u r o p e a n h e a l t h i n s u r a n c e c a r d : r e v e r s e s i d e o f t h e c a r d

The background is divided by an axis splitting the card area horizontally into two parts of equal size. Part 1 is the top part and part 2
the bottom part.

Five placeholders are positioned thanks to a set of guiding lines:

— symmetrically:

(g)

at 9 mm from the left edge of the card,

(h)

in the middle of the card,

(i)

at 9 mm from the right edge of the card,

— vertically:

(j)

at 3 mm from the left edge of the card,

(k)

at 3 mm from the right edge of the card,

— horizontally:

(l)

in the middle of the card,

(m)

at 2 mm from the bottom edge of the card.

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(c) With magnetic stripe

(d) Without magnetic stripe

3.3.

Background and graphical elements

3.3.1.

C o l o u r s o f t h e b a c k g r o u n d

The colour scheme of the background is as follows (1):

— part 1 is dark blue mixed with purple (2),

— part 2 is one tone of grey/blue (3) which shades slightly darker from the middle to the sides of the card,

— the data field is made up of white stripes to be used as background for each of the individual data lines (see below).

A shading effect has been used on part 2 and the data field to create an illusion of relief, with the light coming from the top left corner
of the card. The free area is in the same colour as either part 2 (without the shading effect) or the data field.

(1) The technical details of the colour scheme are available on request to the Secretariat of the Administrative Commission. They will be provided in the appropriate
format according to the best practices in the professional printing sector (i.e. as a Quark Xpress file. The colour scheme is four colours CMYK and all images are
in TIFF format).

(2) The CMYK references for this colour are C78 M65 Y21 K7.
(3) The CMYK references for the grey are C33 M21 Y13 K1 and the blue C64 M46 Y16 K2.

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3.3.2.

E u r o p e a n m a r k

The European mark is made up of the European stars coloured in white:

— when on the front side of the card, it has a diameter of 15 mm and is positioned vertically below the guiding line ‘d’ and

horizontally centred in part 2 of the background,

— when on the reverse side of the card, it has a diameter of 10 mm and is positioned symmetrically along the vertical axis ‘i’ and

aligned centrally with the free area.

An alternative mark will be used for countries where a European card is to be issued but which are not members of the European
Union.

3.3.3.

D a t a f i e l d

The data field area is made up of white data stripes (five when on the front side and four when on the reverse side) 4 mm high with
inter-spaces of 2 mm:

— when on the front side of the card, the data field is centrally located between the vertical guiding lines ‘b’ and ‘c’ and the horizontal

lines ‘e’ and ‘f’,

— when on the reverse side of the card, the data field is symmetrically located along the ‘h’ vertical axis and between the vertical

guiding lines ‘j’ and ‘k’ and above the horizontal line ‘m’.

3.3.4.

F r e e a r e a

The free area is an area located on the reverse side of the European card and available for national purposes. It can be used e.g. as a
signature stripe or for providing any text, logo or other marking. The content of this area has however no legal value but an
informational value only.

This area is positioned as follows:

— when the European card is implemented on the front side of a card, the reverse side is a free area, without any specifications,

— when the European card is implemented on the reverse side of another card, a free area, without any specifications other than its
dimension, remains available on the reverse side of the card (10 mm high and 52 mm wide). It is symmetrically located along the
‘h’ vertical axis and centred in the area between the magnetic stripe and the data field areas. It can be used by the card issuer to
place an authentication signature stripe or text,

— when there is no magnetic stripe, the free area is 20 mm high instead of 10 mm.

3.4.

Predefined data elements

3.4.1.

C a r d n a m e

Field name

Card name

Description

The common name of the card as decided by the CASSTM in Decision No 189

Position

— When on the front side, below the horizontal guiding line ‘d’, and on the right of the vertical

guiding line ‘a’,

— When on the reverse side, symmetrically located along the ‘h’ vertical axis and centred in the

area between the magnetic stripe and the top edge of the card

Values

Format

Length

Remark

The value ‘European health insurance card’ is written in a European Union official language

Font ‘Verdana true type’ or equivalent, in capitals and regular style, 7 point size when on the front
side and 6 point size when on the reverse side, white, with character width compressed to 90 % of
normal size and ‘normal’ position and spacing of characters

40 characters

The precise wording of the name in the language of the issuing Member State is a Member State
responsibility only

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3.4.2.

C a p t i o n

Field name

Caption

Description

The caption identifies the meaning of a data field

Position

On the top of each of the personal data fields

Left alignment for the captions on the left side of the card and right alignment for the captions on
the right side of the card

Values

The values are written in a European Union official language and are set as follows (using English
as the base text):

1.

2.

(No caption for the form identifier)

(No caption for the issuing Member State ID number)

3. Name

4. Given names

5. Date of birth

6.

7.

8.

9.

Personal identification number

Identification number of the institution

Identification number of the card

Expiry date

Format

Length

Remark

Font ‘Verdana true type’ or equivalent, in italic and regular style, 5 point size, white, with character
width compressed to 90 % of normal size and ‘normal’ position and spacing of characters.

Line spacing of 2 points plus character size

As needed by each of the above fixed values

Each caption is unambiguously identified by a number, in order to allow card superposition in
different languages.

The precise wording of the caption values in the language of the issuing Member State is a Member
State responsibility only

3.4.3.

I s s u i n g S t a t e

Field name

Issuing State ID number

Description

Identification code of the card issuer’s State

Position

Values

Format

Length

Remark

Field 2: centrally positioned within the European mark with a white square 4 mm high and 4 mm
wide

The 2 digit ISO country code (ISO 3166-1)

Font ‘Verdana true type’ or equivalent, in capitals and regular style, 7 point size, black, with
character width compressed to 90 % of normal size and ‘normal’ position and spacing of characters

2 characters

The code ‘UK’ will be used instead of ‘GB’, the standard ISO code for United Kingdom.

One single code will be used for each Member State

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3.5.

Personal data elements

The personal data elements have the following common characteristics:

— compliance with EN 1387 with regard to the character set: Latin alphabet No 1 (ISO 8859-1),

— if there is a need to abbreviate elements due to the limited number of spaces, this must be indicated by a full stop.

Data will be laser or thermal-transfer printed or engraved but not embossed.

Each data element will be placed in the data field according to the schemes below.

Figure 3: front side model for the data field

3.5.1.

F o r m i d e n t i f i e r

Figure 4: reverse side model for the data field

Field name

Form identifier

Description

The name of the form which is replaced by the card

Position

Field 1:

— when on the front side, below the horizontal guiding line ‘d’, and on the left of the vertical

guiding line ‘c’,

— when on the reverse side, symmetrically located along the ‘g’ vertical axis and aligned centrally

with the free area

In both situations, it is positioned within a white rectangle 4 mm high and 10 mm wide.

— ‘E-111’ as an entitlement to immediate health care benefits

— ‘E-111 +’ as an entitlement to necessary health care benefits

— ‘E-111 B’ as an entitlement, in Belgium, limited to hospitalisation

Font ‘Verdana true type’ or equivalent, in capitals and regular style, 7 point size, black, with
character width compressed to 90 % of normal size and ‘normal’ position and spacing of characters

Values

Format

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Length

Remark

Field name

Form identifier

Six characters, the second being a hyphen

After the alignment of rights between all insured persons has been ensured by the appropriate
amendments to Regulations (EEC) No 1408/71 and (EEC) No 574/72, this field will be used only
for the value ‘E-111 B’

3.5.2.

C a r d h o l d e r - r e l a t e d d a t a e l e m e n t s

Note that the card holder may not be the insured person but a beneficiary as the card is individual.

Field name

Name of card holder

Description

The surname of the card holder as used in the issuing Member State

Position

Values

Format

Length

Remark

Field 3

—

Font ‘Verdana true type’ or equivalent, in capitals and regular style, 7 point size, black, with
character width compressed to 90 % of normal size and ‘normal’ position and spacing of characters

Aligned to the left border

Line spacing of 3 points plus character size

Up to 40 characters

The surname field may includes titles, prefix or any other name supplement or prefix

Field name

Given name(s) or middle name(s) of card holder

Description

The first (and middle) name(s) of the card holder as used in the issuing Member State

Position

Values

Format

Length

Remark

Field 4

—

Font ‘Verdana true type’ or equivalent,
compressed to 90 % of normal size and ‘normal’ position and spacing of characters

in regular style, 7 point size, black, character width

Aligned to the left side

Line spacing of 3 points plus character size

Up to 35 characters

The given name field may include initial(s)

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Field name

Date of birth

Description

The date of birth of the card holder as used in the issuing Member State

Position

Values

Format

Length

Remark

Field 5

DD/MM/YYYY, where D stands for day, M for month and Y for year

Font ‘Verdana true type’ or equivalent,
compressed to 90 % of normal size and ‘normal’ position and spacing of characters

in regular style, 7 point size, black, character width

Aligned to the left side when on the front side of the card, but to the right when on the reverse one

Line spacing of 3 points plus character size

10 characters, including a slash between each group

—

Field name

Personal identification number of card holder

Description

The personal identification number detail used by the issuing Member State

Position

Values

Format

Length

Remark

Field 6

See applicable personal identification number

Font ‘Verdana true type’ or equivalent, in regular style, 7 point size, black, with character width
compressed to 90 % of normal size and ‘normal’ position and spacing of characters

Aligned to the right border when on the front side of the card, but to the left when on the reverse
one

Line spacing of 3 points plus character size

Up to 20 characters for the ID code

The personal identification number of the card holder or, when no such number exists, the number
of the insured person from whom the rights of the card holder derive

Personal attributes, such as gender, status of family member, cannot be assigned a dedicated field
on the card. They can, however, be included within the personal identification number

3.5.3.

C o m p e t e n t i n s t i t u t i o n r e l a t e d d a t a e l e m e n t s

Field name

Name of the institution

The ‘institution’ is the competent institution of insurance or residence as defined in Annexes 2
and 3 to Regulation (EEC) No 574/72

Field 7, part 1

The acronym of the institution is provided instead of the full name

Description

Position

Values

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Field name

Name of the institution

Format

Font ‘Verdana true type’ or equivalent, in regular style, 7 point size, black, with character width
compressed to 90 % of normal size and ‘normal’ position and spacing of characters

Field 7 is aligned to the right border and part 1 is to the right of part 2

Line spacing of 3 points plus character size

Length

Up to 15 characters

Two spaces and an hyphen will separate part 1 from part 2

The length of this part can be extended as far as the length of part 2 can be reduced

Remark

The acronym is provided as a means to detect a possible data capture problem in the identification
code of the institution (field 7, part 2) and thus ensure quality control of the identification number
of the institution

The full name of the institution will be provided on the basis of the acronym or the identification
code of the institution e.g. by an online tool available on the Internet

No full stop will be used in the acronym

Field name

Identification number of the institution

Description

Identification code awarded nationally to the ‘institution’, namely the competent institution of
insurance or residence as defined in Annexes 2 and 3 to Regulation (EEC) No 574/72

Position

Values

Format

Length

Remark

Field 7, part 2

See national code list of competent institutions

Font ‘Verdana true type’ or equivalent, in regular style, 7 point size, black, with character width
compressed to 90 % of normal size and ‘normal’ position and spacing of characters

Field 7 is aligned to the right border and part 2 is to the left of part 1.

Line spacing of 3 points plus character size

Between 4 and 10 characters

Complementary up-to-date and historical information which may be required for communicating
with the institution could be made available on the Internet thanks to a knowledge centre tool

The competent institution may be different from the liaison body or the organisation in charge of
the cross-border reimbursement as well as from the organisation in charge of technically issuing
the European health insurance card. This information could also be made available on the Internet
thanks to a knowledge centre tool

3.5.4.

C a r d r e l a t e d d a t a e l e m e n t s

Field name

Logical identification number of the card

Description

Logical individual number aiming at uniquely identifying the card and assigned to each card by the
card issuer. It is made up of two parts, the issuer identifier number and the serial number of the
card

Position

Field 8

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Field name

Logical identification number of the card

Values

Format

Length

Remark

The first 10 characters identify the card issuer in compliance with standard EN 1867 of 1997

The last 10 digits constitute the unique serial number

Font ‘Verdana true type’ or equivalent, in regular style, 7 point size, black, with character width
compressed to 90 % of normal size and ‘normal’ position and spacing of characters

Line spacing of 3 points plus character size

20 characters (with leading 0 as needed in the 10 digits used for the unique serial number of the
card)

For assigning an issuer identifier number, an ad hoc registration procedure may be used, instead of
the official one as defined in standard EN 1867, in the Member States which issue European health
insurance cards without an electronic component

This logical card ID number must enable the information carried by the card to be checked against
the information held by the issuing organisation for the same logical number, for example in order
to reduce the risk of fraud or to identify errors in data entry when processing the information of
the card for claim reimbursement purposes

Field name

Expiry date

Description

End date of the entitlement to receive health care during a temporary stay in a Member State other
than the insuring Member State

Position

Values

Format

Length

Remark

Field 9

DD/MM/YYYY, where D stands for day, M for month and Y for year

Font ‘Verdana true type’ or equivalent, in regular style, 7 point size, black, with character width
compressed to 90 % of normal size and ‘normal’ position and spacing of characters

Aligned to the right border

Line spacing of 3 points plus character size

10 characters, including a slash between each group

A Member State will be entitled to claim reimbursement for health care costs provided during the
validity period of the card, although the entitlement period may be different from the validity
period of the card.

3.6.

Security requirements

All security measures remain the full responsibility of the card issuer, who is best placed to assess threats and implement appropriate
counter-measures.

When placed on the reverse side of a national card, the European card will benefit from all security measures applied to the national
card. As an additional security measure, it is, however, suggested that some data have the same values on both sides of the card.

Should other elements than those specified above be considered as required security measures (e.g. a picture of the card holder’s face),
then they will be applied on the other side of the card.

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MODEL OF THE PROVISIONAL CERTIFICATE REPLACING THE EUROPEAN HEALTH INSURANCE CARD

ANNEX 2

1.

Introduction

The European health insurance certificate (called ‘the certificate’ hereafter) may be provided to the insured person, on request only and as a
provisional replacement for the European card.

The certificate is identical in format in all Member States and contains, in the same order, the same data as the European card (fields 1 to 9)
as well as data for certifying the origin and validity of the certificate (fields (a) to (d)).

2. Model of certificate

See next page.

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