The States signatory to this Agreement,
Considering the pertinent clauses of the Final Act of the Conference on Security and
Co-operation in Europe,
Recalling the recommendations of the European Regional Conferences of the International
Labour Organisation on the development of co-operation in the field of social security,
Bearing in mind the importance of the problems of social security requiring solutions
in the light of the expansion of mutual links among those States and of the number
of persons temporarily resident in the territory of a State other than the one whose
legislation entitles them to medical care,
Have agreed on the following provisions:
For the purposes of this Agreement -
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(a) the term “Contracting Party” means any State which has deposited an instrument of
ratification;
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(b) the term “legislation” means any laws, regulations and other statutory instruments
which are in force at the time of signature of this Agreement or may enter into force
subsequently in the whole or any part of the territory of each Contracting Party and
which relate to social security schemes governing the provision of medical care, including
national health services;
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(c) the term “social security convention” means any bilateral or multilateral agreement
by which, in the field of medical care, two or more Contracting Parties are, or may
subsequently be, bound exclusively, and any multilateral agreement by which at least
two Contracting Parties and one or more other States are, or may subsequently be,
bound;
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(d) the term “competent authority” means the minister, ministers or other corresponding
authority responsible for the application of the legislation of each Contracting Party
in all or any part of the territory of that Party;
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(e) term “competent institution” means -
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(i) in relation to a social insurance scheme, the institution of the Contracting Party
to which the person concerned is able to prove that he is entitled to receive medical
care or would be able to prove that he is so entitled if he were in the territory
of that Party;
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(ii) in relation to a scheme other than a social insurance scheme, the institution designated
by the competent authority of the Contracting Party in question;
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(f) the term “competent State” means the Contracting Party in whose territory the competent
institution is situated;
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(g) the term “temporary residence” means a temporary stay in the territory of a Contracting
Party other than the competent State within the limits of such period as may be prescribed
by the national regulations of the first Party, should such exist;
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(h) the term “institution of the place of temporary residence” means the institution empowered
to provide medical care at the place where the person concerned is temporarily resident,
according to the legislation of the Contracting Party which this institution applies;
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(i) the term “medical care” covers medical care required in cases of accident, illness
or pregnancy;
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(j) the term “cases of absolute urgency” means cases where the provision of medical care
or allied benefits cannot be deferred without endangering the life or health of the
person concerned.
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2 However, if the legislation of a Contracting Party embraces several medical care systems,
that Party may specify in Annex I the medical care systems covered by its legislation
and to which this Agreement is applicable, in its relations with any other Contracting
Party with whom it has agreed to apply the provisions of Article 6, paragraph 1, subparagraphs
(b) or (c).
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3 Each Contracting Party concerned shall, in accordance with the provisions of Article
18, paragraph 1, notify any amendment to Annex I.
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1 In the relations between Contracting Parties, this Agreement replaces the corresponding
provisions of any social security convention, provided that such provisions, by mutual
agreement between the Contracting Parties concerned, are mentioned in Annex II.
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2 The Contracting Parties concerned, by mutual agreement, shall give notice, in respect
of themselves, in accordance with the provisions of Article 18, paragraph 1, of any
amendment to be made to Annex II.
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1 Persons covered by the provisions of this Agreement and whose condition, on medical
advise, necessitates immediate medical care during temporary residence in the territory
of a Contracting Party other than the competent State shall receive the medical care
required by their condition, as if they were entitled to such care under the legislation
of that Party. Such care shall be provided by the institution of the place of temporary
residence in accordance with the provisions of the legislation applied by that institution,
as if the persons concerned were covered by it, until their recovery or until their
state of health permits them, on medical advice, to return or be repatriated to the
territory of the Contracting Party where they reside, in accordance with the provisions
of paragraph 3.
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2 However, in the relations between institutions which apply the provisions of Article
6, paragraph 1, subparagraph (b), the supply of prosthetic appliances, major aids
and other major benefits in kind to be specified by mutual agreement by the competent
authorities of the Contracting Parties concerned shall be conditional upon authorisation
by the competent institution. However, such authorisation is not required in cases
of absolute urgency.
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3 If the condition of a person referred to in paragraph 1 does not permit him to return
without help to the territory of the State where he resides, but nevertheless does
not prevent his being moved, the institution of the place of temporary residence shall
make the necessary arrangements for his repatriation to the territory of that State,
in co-operation with the competent institution, provided that an agreement has been
concluded for this purpose between the Contracting Parties concerned or their competent
authorities.
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4 Where the legislation applied by the institution of the place of temporary residence
provides for several medical care schemes, the rules to be applied in respect of the
provision of medical care by virtue of the provisions of paragraph 1 shall be those
of the general scheme or, failing that, of the scheme for employed persons in industry.
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1 In order to receive the medical care provided for in Article 4, paragraph 1, the person
concerned shall submit proof of his entitlement to medical care under the legislation
of a Contracting Party other than the one in whose territory he is present.
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3 Where the person concerned is entitled to medical care under the legislation of a
Contracting Party which guarantees such entitlement to all nationals or all residents
of that Party, the person concerned may be permitted to submit, instead of the certificate
referred to in paragraph 2, his passport or another identity document recognised as
equivalent if the competent authorities of the Contracting Parties concerned have
so decided by mutual agreement.
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4 In cases of absolute urgency medical care shall not be withheld from the person concerned
on the ground that he cannot submit at the appropriate time the certificate referred
to in paragraph 2 or one of the documents referred to in paragraph 3. However, in
such case, the institution of the place of temporary residence shall ask the competent
institution to determine whether the person concerned is entitled to benefit from
the provisions of this Agreement.
Notwithstanding the provisions of paragraph 1 of Article 2, the Contracting Parties
which have agreed to apply the provisions of subparagraph (b) or subparagraph (c)
of paragraph 1 of Article 6 may resolve, through mutual agreement, difficulties arising
from the application of the preceding sentence of this paragraph.
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5 If the life or health of a person needing medical care are seriously in danger, or
the person hospitalised is under 18 and away from his family, it would be desirable,
in the interest of the person concerned, that the consular authority of the Contracting
Party in whose territory that person is resident should be informed.
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2 In the relations between Contracting Parties which have agreed to apply the provisions
of paragraph 1, subparagraph (b), the competent institution shall refund the actual
amount of the costs of medical care borne by the institution of the place of temporary
residence, by virtue of the provisions of Article 4, as shown in the accounts of that
institution. The amount of the costs to be refunded may not exceed the actual amount
for identical medical care that would have been provided to beneficiaries normally
covered by the institution of the place of temporary residence.
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3 In the relations between Contracting Parties which have agreed to apply the provisions
of paragraph 1, subparagraph (c), the competent institution shall refund the amount
of the costs of medical care borne by the institution of the place of temporary residence,
by virtue of the provisions of Article 4, in accordance with the specific arrangements
reached between these Parties, notably on the basis of lump-sum payments determined
by mutual agreement between the competent authorities of the Contracting Parties concerned,
from all the appropriate references drawn from the data available.
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1 Where, under this Agreement, the institution of one Contracting Party is liable to
pay sums in refund of costs borne by the institution of another Contracting Party,
its liability shall be expressed in currency of the second Party. The first institution
may validly discharge its liability in that currency, unless the Contracting Parties
concerned have agreed on other arrangements.
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2 Transfers of funds which result from the application of this Agreement shall be effected,
if such exist, in accordance with the relevant agreements in force between the Contracting
Parties concerned at the date of transfer. Where no such arrangements exist, specific
agreements should be concluded between the Parties concerned.
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2 For the purpose of applying this Agreement the authorities and institutions of the
Contracting Parties shall assist one another as if it were a matter of applying their
own legislation. In principle the administrative assistance furnished by the said
authorities and institutions to one another shall be free of charge. However, the
competent authorities of the Contracting Parties may agree to reimburse certain expenses.
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1 Any exemption from, or reduction of, taxes, stamp duty, legal dues or registration
fees provided for in the legislation of one Contracting Party in connection with certificates
or documents required to be produced for the purposes of the legislation of that Party
shall be extended to similar certificates and documents required to be produced for
the purposes of the legislation of another Contracting Party or of this Agreement.
Any claim or appeal that, under the legislation of a Contracting Party, should have
been submitted within a specified time to an institution of that Party shall be admissible
if it is submitted within the same period to a corresponding institution of another
Contracting Party. In such event the institution receiving the claim or appeal shall
forward it without delay to the institution of the First Parties competent to deal
with it either directly or through the intermediary of the competent authorities of
the Contracting Party concerned. The date on which any claim or appeal was submitted
to an institution of the second Party shall be deemed to be the date of its submission
to the institution competent to deal with it.
The claims, declarations, appeals and other papers submitted to an authority or to
an institution of a Contracting Party with a view to application of this Agreement
shall not be rejected on the ground that they are drafted in an official language
of another Contracting Party.
Any dispute arising between two or more Contracting Parties in connection with the
interpretation or application of this Agreement shall be settled by direct negotiation
between the competent authorities of the Contracting Parties concerned. If there is
a question which affects all the Contracting Parties, the Director-General of the
International Labour Office may submit the dispute, at the request of these authorities
and after consultation with the competent authorities of the other Contracting Parties,
to a meeting of representatives of the competent authorities of all the Contracting
Parties, which will give an opinion on the question.
The annexes referred to in Article 2, paragraph 2, and Article 3, paragraph 1, and
any subsequent amendments made to these annexes, shall be an integral part of this
Agreement.
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2 However, the Contracting Parties to this Agreement shall be allowed a period of six
months from the date on which the instrument of ratification of any acceding State
is deposited, in accordance with paragraph 5, for notifying their objection to such
accession, in accordance with the provisions of Article 18, paragraph 1.
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3 Likewise, any European State ratifying this Agreement after the expiry of the two-year
period provided for in paragraph 1 of this Article may, at the time when such instruments
of ratification are deposited, avail itself of the same right of objection against
any Contracting Party which has acceded prior to the date of such deposit, by notifying
it in accordance with the provisions of Article 18, paragraph 1.
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1 In the relations between an acceding State and a Contracting Party which has not expressed
objection to the accession of that State, this Agreement shall come into force on
the first day of the second month following that in which expires the six-month period
available to that Party, by virtue of Article 14, paragraph 2, to lodge an objection
or, with regard to a European State to which Article 14, paragraphe 3, applies, on
the first day of the second month following that in which its instrument of ratification
is deposited.
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2 The Contracting Parties shall give notice, in accordance with the provisions of Article
18, paragraph 1, which of the provisions of subparagraph (a), of subparagraph (b)
or of subparagraph (c) of paragraph 1 of Article 6, they have agreed to apply in their
relations with one another.
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3 If two or more Contracting Parties have not, when this Agreement comes into force
in relation to them, concluded an arrangement on the application of the provisions
referred to in the preceding paragraph and, as the case may be, an agreement of the
type referred to in paragraph 2 of Article 7, the Agreement shall not take effect
between those Parties until such arrangements become applicable in their relations
with one another.
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4 In the cases referred to in the preceding paragraph of this Article, the Contracting
Parties concerned shall give notice, in accordance with the provisions of Article
18, paragraph 1, of the date on which this Agreement will take effect between them.
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2 However, any Contracting Party may denounce this Agreement after the expiry of a period
of five years from the date on which the said Agreement first comes into force by
giving notice in accordance with the provisions of Article 18, paragraph 1. Such denunciation
shall not take effect until six months after it has been registered by the Director-General
of the International Labour Office.
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2 On receipt of a request to this effect, the Director-General of the International
Labour Office shall inform the other Contracting Parties thereof and, after consultation
with the competent authorities of the Contracting Parties, may convene a meeting of
representatives of the Contracting Parties and the signatory States.
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1 The notifications referred to in Article 2, paragraph 3, Article 3, paragraph 2, Article
14, paragraphs 2 and 3, Article 15, paragraphs 2 and 4, and Article 16, paragraph
2, shall be addressed to the Director-General of the International Labour Office.
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2 In accordance with Article 102 of the Charter of the United Nations, the Director-General of the International Labour Office shall communicate to the
Secretary-General of the United Nations, for registration, any ratification and any
denunciation of which he has been notified.
An original of each of the English, French, German, Russian and Spanish texts of this
Agreement shall be deposited in the archives of the International Labour Office. The
English and French texts are equally authoritative.
