When planning medical treatment in another EU country, you should be aware that reimbursement and procedures are different depending on whether your planned treatment is in a hospital or not:
Hospital treatment: you must ask your health insurer for authorisation before being treated in a hospital abroad. If you fail to do so, your insurer might refuse to reimburse you.
Non-hospital treatment: although it is always advisable to discuss planned medical treatment abroad with your health insurer first, when you are in another EU country you may get any non-hospital treatment you are entitled to in your home country without their prior authorisation. You will have to pay the costs yourself first, and you can claim reimbursement on your return, up to the level provided by your country's healthcare system. If you ask for and receive prior authorisation, you will be covered at whichever rate is higher: the one in the country where you are insured, or the one in the country where you received treatment.
Ask your health insurer for prior authorisation before going abroad for planned hospital treatment.
Your health insurer cannot refuse your request for prior authorization if the specific treatment you need is not available in your home country, but is covered by your statutory health insurer, or if you cannot receive the treatment you need without undue delay in your country, taking into account the medical circumstances of your case (such as, for example, your degree of pain, or your inability to work).
Reimbursement of hospital treatment
Once authorised to seek hospital treatment in another EU country, you should be treated there on the same terms – and charged the same costs – as a person insured in that country:
in the countries where healthcare is free, you should receive free treatment.
in countries where the patient pays for treatment and is then reimbursed by their health insurer, you may have to bear some costs. You should seek reimbursement from the authorities in the country where you are treated, and be reimbursed at the same rates as local residents (the health insurance authorities in the country of treatment will then liaise with their counterpart in your country to claim repayment – so your health insurance will end up paying for your treatment, but that need not concern you).
If the reimbursement rate for the treatment you received abroad is higher in the country where you are insured, you are entitled, upon your request, to a supplementary reimbursement from your health insurer to cover the difference.
Reimbursement for non-hospital treatment
For non-hospital health care which you obtained without prior authorisation, you will be reimbursed at the rate applied in the country where you are insured.
Kris, who lives in EU country A and is insured there, went to EU country B for dental treatment. She organised her treatment and her stay in country B some weeks in advance. Once back home, she submitted her dentist’s bills to her health insurer, which refused to reimburse her.
If the planned dental treatment is not hospital treatment and was obtained without prior authorisation, Kris should be reimbursed at the rate applied in country A, on the terms applicable there.
If the planned dental treatment was not hospital treatment and was obtained with prior authorisation, Kris could be reimbursed either in country A or country B, at the rates which are the most advantageous for her, and up to the costs incurred by her.
If Kris received planned hospital treatment, she should have asked her health insurer for authorisation before leaving in order to be reimbursed. She could then have been reimbursed at the rates which are the most advantageous (either in country A or country B), up to the costs incurred by her. Since she did not ask for prior authorisation, there is no guarantee that her claim will be accepted.