EHIC Application form for Pensioners / Insured Persons resident in other EU / EEA States

Under EU Regulation 883/04 Ireland is responsible for issuing EHICs for

  • People who live in an EEA stater other than Ireland
  • Irish Pensioners and their dependents
  • Dependents of persons who are insured in Ireland

If you are in one of these categories you should have registered your E121, E106 or E109 Form with the appropriate health authority in the State of residence.

You may apply online for the EHIC using the EHIC Application Form for Residents in other Member States

To fill in the form you need

·         Names and Dates of Birth for applicant and any dependents for which you are applying.

·         Personal Public Services Number (PPS Number) of the applicant and any dependents for which you are applying.

The PPS Number is a unique reference number that is used by an individual with all Public Service Agencies in Ireland.  It is issued by the Department of Social Protection in Ireland.  The format of the number is always 7 numbers followed by either one or two letters. For more information see www.welfare.ie

·         Your current address (must be outside Irish State)
·         Your last address in Ireland if appropriate
·         Date on which your E121/106/109 form was registered with the appropriate authority in your State of reference.

Application Form and Explanatory Notes
Apply using the EHIC Application Form for Residents in other Member States
Return to

EU Regulations Office,HSE, St Joseph's Hospital, Mulgrave Street, Limerick, Ireland.

If you can't print the form you can request the form be posted to you.