European Cross Border Healthcare

Most people receive their healthcare in the country they live in, through the healthcare system they are covered or insured by. 

There may be times however when you would wish to seek the option to receive planned healthcare in another European Economic Area country.  If so, it is important to ensure that you are fully informed to enable you to make the right choices.

If you are going on holiday or on a business trip in a European Economic Area you should apply for a European Health Insurance Card (EHIC)which is valid in all EEA countries or Switzerland.  The EHIC will give you state healthcare at a reduced cost or sometimes for free.  It is important to note that the EHIC will cover you for treatment should you become ill or have an accident whilst abroad, it does not cover any planned treatment or operations.
 
Further information on the EHIC and how to apply can be obtained at NHS Choices - EHIC

If you are thinking of travelling to another EEA country specifically for planned medical treatment, the EHIC will not cover you for this.  There are two ways to obtain planned medical treatment in an EEA country, both are different in what is provided and how it is funded 

1.    S2 (E112) Route; or
2.    European Union Directive on Cross Border Healthcare (Article 56) route

S2 Route

The S2 entitles you, in certain circumstances, to access state funded healthcare in another EEA country or Switzerland.  A list of the countries is provided below. 

Treatment is provided under the same conditions of care and payment as for residents of that country, and in a number these countries, as in the UK, care is completely free.  This means the S2 route will cover 100% of the healthcare costs.  However, in some countries, the patient has to pay a percentage of the costs personally, for example, patients cover 25% of the costs of their state provided treatment, known as a “co-payment charge”.  The state covers the other 75%. 

If you were to receive treatment under a country’s healthcare system that applies a “co-payment charge”, you would be expected to pay the same co-payment charge as a patient of that country – the home state pays the balance.  You may be able to claim back some or all of the co-payment when you return to the UK through the Department of Work and Pensions.

How to Apply

You will be required to contact NHS Tayside for prior authorisation of your planned treatment in another EEA country or Switzerland.  Please refer to the contact details below.  In deciding whether to approve your application, NHS Tayside will need to be satisfied that
 
  • You are ordinarily resident in Scotland and are entitled to treatment under the NHS
  • An NHS Consultant has recommended in writing that you be treated in the other country, and that a full clinical assessment has been carried out to demonstrate that the treatment will meet your specific needs
  • The costs of sending you abroad for treatment are justified against the Board's responsibilities for spending money efficiently and fairly, in the interests of all NHS Tayside patients being looked after
  • The treatment is available under the other country's state health scheme and it has agreed to accept you


Should NHS Tayside recommend that you go to another EEA country or Switzerland for treatment, the appropriate paperwork will be passed to the Overseas Healthcare Team at the Department of Work and Pensions in Newcastle. The Overseas Team will issue you with an S2 Form which you will require to take with you to the other country that has agreed to provide your treatment.

See link to application form at bottom of page.

Countries Where Patients Can Be Treated Under the S2 Scheme

Austria
Latvia
Belgium
Liechtenstein
Bulgaria
Lithuania
Cyprus
Luxembourg
Czech Republic
Malta
Denmark
Netherlands
Estonia
Norway
Finland
Poland
France
Portugal
Germany
Romania
Greece
Slovakia
Hungary
Slovenia
Iceland
Spain
Ireland
Sweden
Italy
Switzerland

EU Directive on Cross Border Healthcare (Article 56)

Under the terms of the EU Directive on Cross Border Healthcare (Article 56) patients can choose to obtain a healthcare service, including private healthcare, in another EEA country that is the same as or equivalent to a treatment that would have been provided to the patient within the NHS in the circumstances of the individual patient’s case.  A list of the EEA countries is provided below.

Before considering travelling to another EEA country for planned medical treatment under the EU Directive, please read the advice provided on the NHS Inform National Contact Point web site NHS Inform - Care, Support and Rights.
 
If eligible, you have the right to claim reimbursement under the EU Directive for the cost of treatment within another EEA country up to the amount it would have cost had the treatment been provided by the NHS, or the actual amount where this is lower than the NHS cost. Reimbursement will not be made under the EU Directive for any travel insurance or accommodation costs. You will require to pay the costs of your treatment in another EEA country up front to your EEA state health provider.

How to apply

Prior authorisation must be obtained if the planned medical treatment you are looking to obtain in another EEA country is included in the list of specialised services. These services are outlined in the  Manual for Prescribed Specialised Services.

It is strongly advised that you contact NHS Tayside in advance of travelling to another EEA country for planned medical treatment to establish as to whether the treatment required is one that the NHS offers and thus can be considered for reimbursement under the EU Directive; how much you can be reimbursed for your treatment; and the process for claiming reimbursement, if eligible.

If you are choosing to seek treatment for drug or alcohol rehabilitation services it is a condition that an NHS assessment has been carried out by your NHS Tayside General Practitioner before you travel for treatment.

In deciding whether to approve your application, NHS Tayside will need to be satisfied that:

  • You are eligible for NHS treatment
  • The treatment you are seeking is the same as or equivalent to treatment provided by NHS Scotland
  • There is evidence of clinical need for the treatment you wish to receive

See link to application form at bottom of page.

Countries Where Patients Can Be Treated Under the EU Directive

Austria
Latvia
Belgium
Liechtenstein
Bulgaria
Lithuania
Cyprus
Luxembourg
Czech Republic
Malta
Denmark
Netherlands
Estonia
Norway
Finland
Poland
France
Portugal
Germany
Romania
GreeceSlovakia
Hungary
Slovenia
Iceland
Spain
Ireland
Sweden
Italy
 

Important Note

Neither S2 nor EU Directive (Article 56) authorisations will make NHS Tayside liable for the clinical or criminal negligence of practitioners or clinicians in the proposed healthcare provider country.  Any liability of the treating organisation would have to be established in accordance with the legislation of the provider state.

It is important therefore that you satisfy yourself of the quality and outcomes of the service that you are seeking to use. It is strongly advised that you ensure that you have the appropriate medical travel insurance cover before you arrange to travel abroad for any treatment.

Who to contact at NHS Tayside

Enquiries about European cross-border healthcare should be directed to:

Dr Gavin Main
Associate Medical Director
Access Directorate
Medical Physics Block
Level 7
Ninewells Hospital
Dundee
DD1 9SY

Telephone:  (01382) 632920
email:  gavin.main@nhs.net
Ms Lynn Smith
Interim General Manager
Access Directorate
Medical Physics Block
Level 7
Ninewells Hospital
Dundee
DD1 9SY

Telephone:  (01382) 623920
email:  lynn.smith8@nhs.net

Appeals

Appeals regarding European cross-border healthcare should be directed to:

Dr Andrew Russell
Medical Director
Level 10
Ninewells Hospital
Dundee
DD1 9SY
Email: medicaldirector.tayside@nhs.net

Complaints

Complaints about the handling of European cross-border healthcare should be directed to:

Complaints and Feedback Team Lead
Complaints and Feedback Team
Ninewells Hospital
Dundee
DD1 9SY
Telephone:  0800 027 5507
Email:  feedback.tayside@nhs.net
Please note that NHS Tayside takes no responsibility for the accuracy or quality of external websites linked to from this page.
European Healthcare Application Form - NHS Tayside