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Every country has a very different health system, and if you are visiting Liechtenstein then you should be prepared for the system there to be unlike what we have in the UK. For a start, there is only one hospital in the country, and access to other medical care has its own rules. Furthermore, it is extremely difficult to get permission to live in the principality – as you can see, things are done very differently there. The country itself is only 160 square kilometres in size, with a population of just 35,000. For this reason, healthcare facilities are few and far between, but there is a universal healthcare system that somewhat resembles the UK’s NHS.
It’s important to get a good working knowledge of healthcare in Liechtenstein before travelling there to ensure you can make the necessary preparations and know what to do if you need care whilst there. The following gives a rundown of all the pertinent information about healthcare in Liechtenstein.
Healthcare before Brexit
Government advice is that UK citizens purchase travel insurance when they go abroad, regardless of whether there destination is in the EU or beyond. This is a sure way to guarantee that you are covered in the event you require any kind of medical assistance wherever you travel. Anyone needing urgent medical attention will be given emergency care in Liechtenstein.
If you have a valid European Health Insurance Card (EHIC), it will cost 67 CHF (or £52) for EEA, EU, and Swiss nationals to access free emergency healthcare in the same way Liechtenstein nationals do. This is the approximate cost of 1 month’s health insurance when you enter the country, regardless of the length of your trip. Without an EHIC, you can expect to be charged the full amount for any care you receive. This is why it’s important to purchase sufficient travel insurance to fund the medical care you may require.
If you have insurance, be sure to retain receipts and other paperwork related to your care, as this will probably be needed to apply for a refund through your health insurance. The EHIC is the easiest, cheapest way to access state-provided healthcare if you’re staying in Liechtenstein on a temporary basis. Any facility that asks you to pay upfront for your care is probably not a state-controlled clinic. The EHIC doesn’t cover private care, and also won’t help with costs from:
- mountain rescue
- being transported back to the UK
- medical care on cruises
Though travel or hotel representatives may reassure visitors that they can claim back the expenses they pay for care, be warned that this is only true if you have private health insurance. If you receive treatment under the EHIC, you cannot claim the costs back, but the costs you incur are likely to be far less than what private healthcare would cost you.
Healthcare after Brexit
If no deal is struck for when the UK parts ways with the EU, the way UK nationals access healthcare in Liechtenstein is likely to change. If you have plans to visit the country after Brexit, you should take the precaution of purchasing travel insurance to ensure you have the funds to access healthcare whilst you are there. Your EHIC issued by the UK will remain valid until the UK exits the EU, but may not be afterwards.
Having said that, the UK government is working on developing agreements with EU countries like Liechtenstein regarding healthcare arrangements for visiting UK nationals. Look out for updates to the situation regarding the UK and Liechtenstein. This information will be updated when changes to the situation are encountered, so watch this space.
As previously mentioned, there is only one hospital in Liechtenstein. It is named the National Hospital, and is located in Vaduz, the capital city. It runs concurrently with private practitioners, and you will be required to obtain a referral from a doctor to be admitted there, just like in the UK. The only exception to this is if you are in need of emergency care.
The government of Liechtenstein has agreements in place with various hospitals overseas, particularly in Switzerland and Austria. Patients in Liechtenstein who require complex or highly specialised treatments are transferred to one of these hospitals to receive the care they need. This ensures that, no matter the nature of the medical attention a patient needs, there are facilities available to accommodate them. Of course, it could mean delays in accessing urgent medical attention, so be aware of this situation before deciding to travel to Liechtenstein.
The only facilities in Liechtenstein that offer treatment free of charge are state-run facilities like the National Hospital. Even then, you will require a valid EHIC to access care without incurring the full charge. Double check the care being arranged for you isn’t being counted as a private case – all state-run facilities are obliged to accept your EHIC when you present it. Travel insurance documents only have to be provided if you choose to disclose them.
Prescription fees in Liechtenstein are covered by the nation’s statutory health insurance. When an EHIC is involved, people of working age must pay 50% of the total fee, while pensioners are charged in the region of 10%. To qualify for this lower rate, pensioners must declare that they are in receipt of a UK State Pension.
Bringing medication into Liechtenstein
There are various prescription medicines that contains drugs which are controlled by the Misuse of Drugs regulations in the UK. Any drugs that fall under these regulations are subject to extra legal controls, and you may be required to obtain a personal licence to take them overseas. There will also be specific requirements relating to the documentation you must take and the way you are permitted to carry your medications. There is detailed information in the relevant section of the GOV.UK website.
Pre-existing health conditions
It will be necessary to take out medical travel insurance before visiting Liechtenstein if you have a chronic health condition that may require treatment while you are abroad. When you do so, you must be sure that you disclose the details of any pre-existing health conditions you have, no matter how minor you think they are. Failure to do so could invalidate your policy and leave you high and dry when you need to pay for medical treatment. The EHIC can help get treatment for pre-existing conditions up until the UK leaves the EU, but it may not be valid afterwards.
If you know you will require treatment for your pre-existing condition whilst you are in Liechtenstein, you should consult your doctor before leaving to get advice on what to do. Ask them what documents you should carry with you regarding your condition and any medications you take. Anyone travelling to Liechtenstein to obtain medical treatment should learn all their requirements before doing so.
All dental practices in Liechtenstein are privately owned and run, and must be paid for in full. There are no exceptions to this. There are approximately 26 dentists in the country, and their work has to be paid for.
If you have an emergency in Liechtenstein where your life is in danger, you should call the emergency number 112, and you will be connected with the relevant emergency service from there. The other useful numbers are:
- ambulance: 144
- police: 117
- fire department: 118
- air rescue
The only hospital in Liechtenstein is in the city of Vaduz, and you do not need to referred by a doctor in cases of emergency. If you want to be treated under the nation’s state system, you should always call 144 and ask the ambulance to take you to the National Hospital in Vaduz. If a hotel or travel representative arranges your medical care, make sure they don’t set you up with a private clinic, or your treatment could incur some hefty fees.
Working in Liechtenstein
The EHIC only covers you for up to 90 days of residency in Liechtenstein. Any British nationals living and working in the country must engage with the registration process to qualify for the same healthcare entitlements as Liechtenstein citizens. Anyone residing in the country must contribute to the national healthcare fund in tandem with their employers.
Workers posted to Liechtenstein by UK companies may be entitled to receive healthcare funding from the UK. Make contact with HM Revenue and Customs to learn whether this will be an option for you.
Citizens of the EEA who are working in Liechtenstein are legally required to register with the authorities. It is the responsibility of employers to register their new EEA workers with the Migration and Passport Office no more than 10 after they start work. Employees will then be sent confirmation of their official status as a cross-border commuter.
You will not be granted permission to reside in the Principality of Liechtenstein just for being employed by a company registered in the country. You must apply for a residence permit, and part of the application process will involve meeting with a manager, specialist or qualifies worker who has completed an apprenticeship or gained many years of working experience.
UK posted workers may need to take out additional health insurance in Liechtenstein to ensure they are able to access the necessary healthcare treatment. The laws for foreign nationals who wish to reside in Liechtenstein are incredibly restrictive, and once you obtain a residence permit it will only be valid for 5 years.
If you’re a UK resident who has travelled to Liechtenstein to study, a valid European Health Insurance Card will enable you to access state-provided healthcare right up until the UK leaves the EU. It remains to be seen what will happen after that, so you should stay abreast of developments in the negotiations between the UK and EU member states about healthcare for UK citizens after Brexit.
It is recommended that you purchase health insurance to cover your medical care, just as you would if you were staying in a non-EU country, after Brexit. This will ensure you remain covered.
People who are receiving an exportable UK benefit like the contribution-based Employment Support Allowance or the State Pension and living in Liechtenstein may be entitled to have their state healthcare funded by the UK. You will be required to apply for an S1 certificate to get this.
You can make the application through the International Pension Centre at the DWP, though the exportable benefit you receive may dictate the team you need to deal with. There are different rules regarding healthcare cover for different exportable benefits – more information is available in the relevant section of the GOV.UK website.
The S1 certificate exists to help you and any dependants you have access healthcare whilst living in Liechtenstein. Current S1 certificates will remain valid until Brexit is complete, but it is not yet known what will happen after that. You should proceed to apply for an S1 certificate right up until the UK and EU part ways.
The Foreign and Commonwealth Office (FCO) offers information about the benefits from both the UK and Lichtenstein that are accessible to Britons residing in Liechtenstein. It also has information about driving rules in the country, which may be of interest if you’ve never been there before.
So whether you are studying at the famed Universität Liechtenstein, hiking the trails around the Falknis and Naafkopf mountains, or relocating to work in one of the most industrialised nations in the world, you must ensure your healthcare is covered. Emergencies and unexpected illnesses can happen, and you need to make sure you are covered or your medical bills could pile up very quickly. The healthcare system of Liechtenstein is quite accommodating if you have the right things in place, and being covered is just good sense. Don’t take risks with your health – do what you need to do and enjoy your time in Liechtenstein with peace of mind.