The E112 form entitles you to treatment in the state-funded sector in another EEA country and Switzerland. Treatment will be provided under the same conditions of care and payment as residents of that country. This could mean you have to pay a percentage of the costs upfront.
For example, in some countries, patients cover 25% of the costs of their state-provided treatment, known as a 'co-payment charge'. The state would cover the other 75%. If you received treatment under that healthcare system, you would be expected to pay the same co-payment charge as a patient from that country. You may be able to seek reimbursement for this cost when you are back in the UK if you are not able to do so in the other country.
Equally, in some countries care is completely free at the point of delivery, as in the UK. This means the E112 will cover 100% of the costs of your care, so you would not be required to pay any treatment costs upfront.
The system works with the NHS paying the treating country’s contribution. If the amount paid by the NHS to the treating institution on your behalf is less than the treatment would have cost to provide locally in the UK, and you have had to pay co-payment charges, you can claim the reimbursement of these charges up to the cost of providing the care locally by the NHS.
For example, if you go abroad for an operation costing £8,000, and are expected to pay a standard patient co-payment charge of 25%, you will pay £2,000. The NHS will pay the remaining £6,000 to the treating institution.
If the cost of treating you at home would have been £7,500 you could then claim back the extra £1,500 budgeted by the NHS to help cover the co-payment charge that you have paid.
Since the treatment is £500 more expensive than on the NHS, you would have to pay this portion yourself, and could not be reimbursed for it.
How to apply for an E112
You will need to apply to your local health commissioner for their written agreement to recommend funding for treatment. In making this decision, your local commissioner will need to be satisfied that:
- A UK NHS consultant has recommended in writing that you be treated in the other EU 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 health commissioner’s responsibilities for spending money efficiently and fairly, in the interest of all the patients they look after.
- The treatment is available under the other country’s state health scheme.
- You are entitled to treatment under the NHS.
If your commissioner agrees that you should go abroad for treatment, the appropriate paperwork should be passed to the Overseas Healthcare Team in Newcastle. They will consider the issue of the E112 form. If issued, you will need to take this form with you to the other member state where you are going for treatment. For more information phone 0191 218 1999.
Last reviewed: 30/04/2009
Next review due: 29/04/2011
