Planned treatment in the EU

Healthcare is considered to be planned when the patient travels to another EU member state with the intention to receive healthcare services.

There are two routes for your health insurance fund to cover the costs for planned treatment in the EU.

You can either:
  • Apply for authorization for the treatment by the competent health insurance body, which issues the E112 or S2 form for this purpose. This form indicates to the state of treatment that you wish to be treated as if you were insured by the state’s public health system and that your national health insurance fund will reimburse the costs. Doctors’ fees not covered by the E112 or S2 forms, as well as any patient’s contribution, prescribed by the national legislation of the country of treatment, are not reimbursed by the national health insurance institution. You should always have authorization for planned treatment in order for your national health insurer to bear the cost of the treatment.
    In this case, your entitlement to treatment derives from the European Regulations (EC) for the coordination of social security systems 883/2004 & 987/2009 or,

  • Pay in advance the cost of your treatment abroad and then request the reimbursement of the costs by the national health insurance fund when you return home. If you are entitled to this healthcare treatment at home, then you will be reimbursed by the national health insurance fund. The reimbursement will be up to the cost of that treatment at home. For some types of treatments, prior authorization may be required.
    In this case, your entitlement to treatment derives from the Directive 2011/24/EU on the rights of patients in cross-border healthcare as transposed into national legislation by Law 4213/13.

TIP

When applying for prior authorization for cross-border treatment, you have the right to have your claim examined pursuant to the Regulation (EC) 883/2004 and in case the conditions of the Regulation (EC) have not been met, also pursuant to the Directive 2011/24/EU.

TIP

There are significant differences between the Regulation (EC) and the Directive, in particular as regards the terms and conditions, the ways and the amount of cost coverage of planned treatment by the competent national health insurer. Make sure you know before you travel.

TIP

You may have additional rights to treatment abroad based on your national law or bilateral/multilateral Social Security Agreements. We recommend that you contact your national health insurance fund for further information before you make any final decisions.

  • You'll always need authorization for planned treatment either for inpatient or outpatient status.

  • There is a reimbursement mechanism of the costs for health benefits in kind among member states. Do not worry about paying the invoices but remember that doctors’ fees that are not covered by the E112 or S2 forms, or any patient’s contribution, prescribed by national law of the state of treatment, are not reimbursed by the national health insurance fund and are paid privately.

  • With the E112 or S2 forms you have access to healthcare professionals that are public or contracted with the public healthcare system in the state of treatment.

  • Your entitlement to sickness benefits in kind in the country of the treatment is limited to the total benefits provided by the country’s public health insurance system.

  • You have the right to seek the expertise of public or private healthcare providers.

  • The range of healthcare benefits that you can seek, is the health benefits that you are entitled to in the country you have statutory health insurance.

  • You may require prior authorization for some types of treatment. Make sure you are well informed before travelling.

  • You have to pay for the treatment that you will receive and seek the reimbursement of your expenses when you return home.

  • The amount of the reimbursement that you will receive by your health insurance fund will be equal to the reimbursable price for the same kind of treatment if it was delivered at home.

  • On issues of patient’s safety and quality of treatment, professional liability and complaints in the event of harm, the relevant legislation and regulations of the state of treatment are implemented.

  • For further information, you are advised to contact your national contact point for cross-border healthcare before you travel.