The following table gives an overview of different pathways to cover the costs of treatment abroad.

PathwayWho?What?How?Procedure
Directive 24/2011All EU permanent residents contributing to the healthcare system of a member stateAny treatment that has an equivalent covered by the patient’s healthcare package at home. This treatment can be both emergency / unpostponable or routine and can be provided by both public and private medical centres.Travel, accommodation and translation may be covered, but not necessarily (every member state gets to decide)..The patient has to cover out of pocket all costs of the treatment and can then claim reimbursement from their national healthcare provider up to the amount allocated for the same treatment in their country of insurance.Reimbursement has to be claimed by the patient from their health insurance authority after the treatment if it does not require prior authorization. If it does require prior authorization, it has to be  granted by the authority prior to departure. If applicable, the patient is to be redirected to the more beneficial S2 procedure.
S1Cross-border workers who contribute to the healthcare system of an EU member state, their spouses and children.
Pensioners who have contributed to the healthcare system of a EU member state.
All routine and emergency healthcare available to patients with a health insurance in the country of treatment.All costs covered directly between healthcare authorities, no upfront payments by the patient beside any that would have also incurred for a local patient in the country of treatment.Standardized Form S1 filled by the citizen, issued by their health insurance authority and submitted to the health insurance authority in the country of treatment. 
S2All permanent residents of the EU contributing to the healthcare system of a member statePlanned treatment that is part of the healthcare package of the health insurance of the patient, and of the destination country and is provided by public healthcare providers and cannot be provided in the patient’s home country within a justifiable timeframe.Travel, accommodation and translation may be covered, but not necessarily (every member state gets to decide).All costs covered directly between healthcare authorities, no upfront payments by the patient beside any that would have also incurred for a local patient in the country of treatment.The treatment is subject to prior authorization by the health insurance authority of the patient’s country, upon which a Standardized Form S2 is issued and presented to the healthcare provider (hospital administration). Further requirements for authorization may apply.
EHICEveryone in possession of an EHIC CardAny medical help that is considered an emergency or cannot be safely postponed until you return to your country of insurance.All costs covered directly between healthcare authorities, no upfront payments by the patient beside any that would have also incurred for a local patient in the country of treatmentIssued by the national health insurance authority and presented directly to the healthcare provider (e.g. hospital administration).

Overview of types of coverage

  •  Виктория Илчева
  •  юни 2, 2020
  •  Uncategorized

The following table gives an overview of different pathways to cover the costs of treatment abroad.

PathwayWho?What?How?Procedure
Directive 24/2011All EU permanent residents contributing to the healthcare system of a member stateAny treatment that has an equivalent covered by the patient’s healthcare package at home. This treatment can be both emergency / unpostponable or routine and can be provided by both public and private medical centres.Travel, accommodation and translation may be covered, but not necessarily (every member state gets to decide)..The patient has to cover out of pocket all costs of the treatment and can then claim reimbursement from their national healthcare provider up to the amount allocated for the same treatment in their country of insurance.Reimbursement has to be claimed by the patient from their health insurance authority after the treatment if it does not require prior authorization. If it does require prior authorization, it has to be  granted by the authority prior to departure. If applicable, the patient is to be redirected to the more beneficial S2 procedure.
S1Cross-border workers who contribute to the healthcare system of an EU member state, their spouses and children.
Pensioners who have contributed to the healthcare system of a EU member state.
All routine and emergency healthcare available to patients with a health insurance in the country of treatment.All costs covered directly between healthcare authorities, no upfront payments by the patient beside any that would have also incurred for a local patient in the country of treatment.Standardized Form S1 filled by the citizen, issued by their health insurance authority and submitted to the health insurance authority in the country of treatment. 
S2All permanent residents of the EU contributing to the healthcare system of a member statePlanned treatment that is part of the healthcare package of the health insurance of the patient, and of the destination country and is provided by public healthcare providers and cannot be provided in the patient’s home country within a justifiable timeframe.Travel, accommodation and translation may be covered, but not necessarily (every member state gets to decide).All costs covered directly between healthcare authorities, no upfront payments by the patient beside any that would have also incurred for a local patient in the country of treatment.The treatment is subject to prior authorization by the health insurance authority of the patient’s country, upon which a Standardized Form S2 is issued and presented to the healthcare provider (hospital administration). Further requirements for authorization may apply.
EHICEveryone in possession of an EHIC CardAny medical help that is considered an emergency or cannot be safely postponed until you return to your country of insurance.All costs covered directly between healthcare authorities, no upfront payments by the patient beside any that would have also incurred for a local patient in the country of treatmentIssued by the national health insurance authority and presented directly to the healthcare provider (e.g. hospital administration).

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  • Planned treatment abroad: Know before you go – Лечение без граници

    вторник, 02 юни, 2020

    […] an overview of all available types of coverage for cross-border healthcare, please see overview types of coverage. For non-planned (emergency or unpostponable) healthcare abroad, please see EHIC. If you are a […]

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