In the EU, thanks to the Cross-Border Healthcare Directive, you have the right to receive healthcare in another EU country if you need it and be reimbursed by your home country’s healthcare system. This is especially useful if you need a treatment that isn’t available where you live. Before you travel for treatment, it’s important to check approval requirements in your home country’s healthcare system and understand how much of the cost will be covered. This will make it easier to get the care you need.
More information about the process
Understand your rights
Under EU law, all citizens have the right to receive healthcare in any EU/EEA Member State. This right is anchored in Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare.
Plan ahead: contact your health insurer first
Before seeking treatment abroad, it’s crucial to:
- Confirm what your health insurance covers and what out-of-pocket costs you might incur. This includes checking if you need prior authorization from your health insurer for planned treatments.
- Understand the reimbursement process. Each country has its own system for reimbursing healthcare costs. It’s vital to know the documentation you’ll need to provide for reimbursement.
If your health insurer agrees, you will receive an S2 document. This document demonstrates to the healthcare provider in the other EU country that you are entitled to the treatment and that your health insurer will reimburse the costs.
Contact National Contact Points
Each EU country has a National Contact Point (NCP) to provide information about cross-border healthcare. NCPs can:
- Explain your rights and entitlements.
- Provide information about reimbursement procedures.
- Offer details about healthcare providers in their country.
Obtain prior authorization
For certain treatments, especially those requiring hospital stays or specialized care, you might need prior authorization from your health insurer. This authorization ensures that:
- The treatment is covered by your insurance.
- You are eligible for reimbursement.
To obtain prior authorization, you typically need to provide:
- Medical documentation recommending the treatment.
- An estimate of the costs.
- Information about the healthcare provider abroad.
Navigate reimbursement
Reimbursement for healthcare costs can vary. You may have to pay the full costs upfront and then seek reimbursement from your home country’s health insurance.
Claim reimbursement
- Keep all invoices, receipts, and medical reports.
- Submit a reimbursement claim to your health insurer.
- Be aware of deadlines for submitting claims to avoid losing your reimbursement rights.
Considerations for long-term care and specialized treatments
For long-term care, rehabilitation, or specialized treatments, additional factors warrant consideration:
- Language barriers: Ensure clear communication with healthcare providers.
- Follow-up care: Plan how you’ll receive post-treatment care once back in your home country.
- Legal and procedural differences: Understand the healthcare system and patient rights in the country where you seek treatment.
Accessing cross-border healthcare in the European Union is a valuable option for many patients, providing greater choice and potentially quicker access to treatments. By understanding your rights, planning ahead, and utilizing resources like NCPs, you can navigate the process smoothly and ensure you receive the care you need.