Planned medical treatment abroad in another EU country
As a EU citizen, you have a right to seek treatment in other EU countries on the same terms and at the same cost as people living in those countries and you are entitled to be reimbursed for care abroad by NHS. For example, you can avoid long waiting lists at home by choosing treatment in another European Union country with spare capacity, and claim reimbursement from NHS.
The EU Legal Framework for medical treatment abroad
In March 2011, the European Directive on the application of patients’ rights in cross-border healthcare was adopted by the European Parliament.
The Directive has two main purposes:
- To clarify the rights of patients to obtain certain planned healthcare in any EU member state and establish the limits of those rights,
- To clarify the position of the member states regarding their legal obligations and assist them in managing the system effectively.
The new Directive on cross border healthcare means that exercising your rights should now be simpler and more straightforward. You should have a much clearer idea of what you are entitled to, and what restrictions your own country can put on these rights. It is important to realise that the new Directive does not give European Union citizens any new rights to cross border healthcare. In essence, you are entitled to obtain healthcare services in any EU state and be entitled for NHS reimbursement.
Essential considerations when choosing treatment
Some types of tretment require permission from NHS and that is called prior authorisation. In principal, you can seek cross border healthcare without prior authorisation. However, provisions in the EU directive allow member states to require prior authorisation in certain instances. These include treatments that:
- Require an overnight hospital stay of at least one night;
- Require use of highly specialized and cost-intensive medical infrastructure or medical equipment, and,
- Present a particular risk for the patient or the population.
In the England, Scotland and Northern Ireland, for example, prior authorisation is required for some inpatient treatments depending on your location. In Wales all overnight inpatient treatment have to be pre-applied.
Costs and reimbursement
The directive provides that member states charge cross border patients the same fees as domestic patients for “comparable medical situations.” This means that if you want to get a hip replacement in abroad you will pay the same fee as local patients and the cost will be covered by your domestic insurance carrier at whichever rate is higher – the State where you are insured or the State where you are receiving treatment. Minimal refunded amount for hip replacement in England is £5431. For example if you pay in Poland £3500, you will be refunded £3500 by NHS, but if costs are higher £8000, you will be refunded at least
£5431, but refunded amount can reach up to £12000 based on your condition.
Aftercare in UK
After treatment, you should be welcomed back into NHS system for aftercare on the same basis as if you had been treated there in the first place. If you chose to go abroad your GP is not allowed to refuse tretment, but if you chose to have your surgery in UK, NHS is not responsible for your tretment. Basically, by choosing going abroad you will still be partly within NHS system.
What if something goes wrong with tretment abroad?
If you have a bad treatment outcome you have the right to file a complaint and seek remedies according to the legislation of the member state where treatment was provided. Every registered healthcare provider has state insurance policy in place for mistreatment and accidents.
Who can help me get tretment abroad?
If you are coming from United Kingdom and you would like to have a surgery in abroad, MedRefund can ensure that you get the cost of this treatment reimbursed by the NHS. From 2013 Medrefund is successfully working for and have helped more than 700 patients seek reimbursement from NHS even when they where initially rejected.