Form E104 is issued to persons based on an application.

1. The application entitles persons to apply for certifications of insurance periods valid in the Health Insurance Fund.
2. The application entitles persons to apply for certifications of insurance periods expired in the Health Insurance Fund.

Attention!

Upon submitting the application, termination of certain insurance covers can be applied for by a:
● child
● retiree
● dependent spouse
● pregnant woman
● foreign student

The Health Insurance Fund does not terminate insurance covers on other bases (e.g. employee, person receiving childcare allowance). In this case, a person must first turn to their insurance company and apply for the termination of the insurance cover. For example, an employee to their employer, a caregiver of a person with a disability to a local government, a person receiving childcare allowance to the Social Insurance Board.

Send or take the application to a client service office where the insurance cover of persons indicated on the application is terminated if necessary. Pursuant to the Population Register Act, the population register must be notified of your new residence if you are moving to another EU member state.

The Health Insurance Fund cannot terminate the abovementioned insurance cover until a corresponding note has been made in the population register!

Client service offices will send form E104 to the address indicated on the application.

You can check the validity of your health insurance cover by calling the information phone of the Health Insurance Fund at 669 6630 (Mon – Fri 8.30 a.m. – 4.30 p.m.).