Leaving Andorra for a few days: the CASS forms for Spain, France and Portugal

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Why your CASS card won't work like an EHIC

Many newcomers assume that because Andorra uses the euro and sits between Spain and France, their health card works across Europe. It doesn't. Andorra is outside the European Union, so the CASS does not issue the European card. Instead it has agreements with its three neighbours, and each one has its own paper form.

This guide covers the outbound trip: you live or work in Andorra and leave for a few days. The opposite case, a European visitor who falls ill in Andorra, is in our EHIC guide. For how the CASS works day to day, see the CASS explained.

One form per country

France works differently from the other two. For outpatient care you pay up front and then pick who refunds you: the CASS, at Andorran rates, or the French CPAM, at French rates. For a CASS refund keep the original invoices, a copy of the medical report, the original prescriptions and the stickers or QR codes from any medicines. Keep them all together from the first day.

The form covers you and your dependants, in the public network only. Private clinics are out.

How to get it

You request it before you travel, in one of three ways:

1. Online, in the private area of the CASS website, using a Government digital certificate or your CASS PIN.
2. At the self-service terminals in CASS offices, with your health card or CASS number.
3. At your Comú (the parish office), with form CASS-0008 and an identity document.

The first two give you the form on the spot. A Comú can take up to 48 hours, so don't leave it to the day before.

How long it lasts

The CASS issues it for 60, 90 or 120 days, and never for more than 6 months in a calendar year. Check the date before every trip. If you nip down to Barcelona every few weeks, it is easy to carry a form that ran out a while ago. Turn up at A&E without a valid one and the hospital may bill you at private rates.

The mistake people make: booked appointments

The forms cover care that cannot wait until you get back to Andorra: emergencies, plus a few treatments that cannot be interrupted, such as oxygen therapy, dialysis and anticoagulant (Sintrom) monitoring.

They do not cover anything you plan. A check-up with the specialist you've seen for years, a dental appointment, tests you had already booked, a second opinion: none of these count. If you want to keep seeing a doctor abroad, expect to pay as a private patient, or check first whether your private policy covers it. Our private health insurance guide explains what top-up cover usually looks like.

There is one exception. Pensioners and students travelling to France are covered for scheduled visits too. Students can also ask the CASS to extend the form with CASS-0034a, and if they study in France without a student mutual, they register the SE130-04 with the CPAM.

When the CASS sends you abroad

A trip you choose is not the same as a referral. If a treatment cannot be done in Andorra and the CASS refers you to a hospital elsewhere, a separate rule applies: transport and accommodation are covered at 100 % of the CASS reference tariff. That goes through its own procedure and has nothing to do with the emergency form.

What the forms leave out

• Any country other than Spain, France and Portugal. Flying home to London, Dublin or New York? The CASS forms are no use there, so you need travel or international health cover.
• Planned care, except for pensioners and students in France.
• Private hospitals and clinics.
• Your own share of the cost.
• Getting you back to Andorra. Repatriation is not on the list of covered acts.

If you have only just started paying in, note that CASS refunds have their own entry rule: the first time, you need 25 days of contributions. To see which covers fit your travel pattern, run the Andorra insurance planner. It gives cover types and steps, never a company name, and the full picture of options is in health insurance in Andorra.

On the blog you will also find CASS waiting periods.