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What is form E104 and why is it important?

The UK authorities are therefore under a duty to accept Form E104 as proof that the named person was covered by the healthcare insurance system of the issuing institution for the period specified in the document.

How do I request s041/e104 (health related benefits)?

Requests for S041/E104 (health related benefits) can only be made by the Institutes in the relevant EU member state. To request your Irish social insurance record please complete the form below and email it to [email protected] or by post to the address below

When was model form E 104 last used?

The model form E 104 was last published by the Administrative Commission for the Coordination of Social Security Systems in its Decision No 202 of 17 March 2005 on model forms necessary for the application of Council Regulations (EEC) No 1408/71 and (EEC) No 574/72 [2006] OJ C 77/1.

Can a person named in form E 104 receive medical treatment?

• the person named in Form E 104 would have been entitled to receive healthcare treatment which became necessary on medical grounds during their stay in the UK (Article 19 of Regulation 883/2004 on the coordination of social security in the EU [2004] OJ L 166/1 or Article 22 of Regulation 1408/71 [1971] OJ L 149/2); and


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