In certain cases, you have the right to organise medical treatment, such as a consultation with a specialist, surgery or treatment for a specific condition, in another EU country and be reimbursed for it by your health insurance institution.
There are two ways to get planned medical treatment in another EU country:
Option 1 - with an S2 form
With an S2 form, your health insurance institution covers the costs of the treatment in another EU country directly.
If you choose this option, you can only access publicly provided healthcare, and you will always need to apply to your national health insurance institution for prior authorisation (known as an S2 form) before you go for treatment abroad. Your health insurer is obliged to give prior authorisation
if the treatment you're applying for is included in your health insurance cover, but
can't be provided to you in your own country within a time limit, which is medically
justifiable.
If you've obtained an S2 form, your treatment costs will be covered according to the rules in the country where you're treated. This will be dealt with by the relevant institutions in your home country and the country of treatment. In principle, you will not have to pay for the treatment.
Warning
If people who are insured in the country where you are treated have to pay for that specific treatment, you will also have to pay and be subsequently reimbursed according to the conditions and reimbursement rates in that country.
Option 2 - claim reimbursement after treatment
You may also pay for your planned medical treatment yourself and be able to get some or all of your costs reimbursed once you get home. This system applies to both public and private healthcare providers in another EU country.
You will be reimbursed according to the reimbursement rates applied for the same treatment
in the country where you're insured. If you're insured in a country that doesn't have
a reimbursement scheme, then your national health insurance body will reimburse you
according to a tariff based on the cost of that treatment to the national healthcare
system.
Warning
Depending on the type of treatment you need and the rules in your country, you might also need prior authorisation from your health insurer. However, the form for prior authorisation under this option is established nationally. Prior authorisation is required by many EU countries for care involving an overnight hospital stay or expensive medical equipment. No prior authorisation can be required for, e.g. a medical consultation.
Ask your health insurer or your National Contact Point whether you need prior authorisation. You can also find links to lists of treatments subject to prior authorisation in your country here. Your application must be granted if you would otherwise have to wait too long for treatment at home. When considering your application, your health insurance body also has an obligation to assess whether it is possible to issue you with an S2 form.
Option 1 with an S2 form will usually be more beneficial to you where the persons who are insured in the country where you are treated do not have to pay for the same treatment or where the reimbursement rules of your home country are more favourable than the rules in the country where the treatment takes place. In the latter case, you will be entitled to a top-up from your health insurer. However, only Option 2 is possible, if you need private healthcare.
Read more about expenses and reimbursements for your planned medical treatment.
Sample story
Check with your National Contact Point and health insurer before organising your treatment
Aurélie lives in France. She needs to undergo surgery and has found a specialist clinic in Luxembourg, where her parents live. She has found a suitable specialist at a public hospital near her parents' house, but isn't certain how to go about organising her treatment there.
Aurélie decided to call the National Contact Point in France and her local health insurance institution. They gave her all the information she needed to apply for prior authorisation and Aurélie completed the required form. If she receives authorisation, she can then arrange her treatment directly at the hospital in Luxembourg.
How to organise your treatment abroad, if you do not need prior authorisation from your health insurer
1. Check your health cover
- check whether the treatment is among the benefits that you're entitled to at home
- check what documents your health insurer requires for reimbursement
- check whether your health insurer requires to comply with any special conditions for the reimbursement of the costs of the treatment you need
- check the reimbursement rate for the treatment you need
2. Find a place to get your treatment
You will need to find a healthcare provider (hospital, medical establishment, etc.) offering the treatment you need in another EU country. To do this, you can:
- ask your National Contact Point in your home country or in the country where you are considering treatment
- find a provider yourself directly
Be aware that healthcare systems in other EU countries may not work in the same way as healthcare in your home country. Furthermore, when accessing planned healthcare treatment without an S2 form in another EU country, you might be treated as a private patient and charged private prices whereas your reimbursement will always be at the level of public prices in your own country. You will therefore have to cover any difference in cost yourself.