Compare application routes

There are some major differences between the two application routes. In conjunction with your local health commissioner, you should decide which route is most suitable.

Payment conditions

S2
The UK will cover the cost of your treatment. However, you may have to pay a contribution towards healthcare costs, depending on what the common practice is in the country of your choice.

EU Directive
You will normally have to pay treatment costs upfront and get reimbursement from your local NHS health commissioner (however, other arrangements may be available on request).

Treating sector

S2
Since this is based on agreements between governments, it is only valid for state sector treatment.

EU Directive
Treatment can be in the state or private sector as the NHS will directly reimburse the fees you have paid.

Application process

S2
You’ll have to apply through your local health commissioner, who will send your application and all necessary paperwork to the Overseas Healthcare Team in Newcastle. They will then issue the S2 form and post it to you. You will need to present the form to the health service provider abroad, such as the hospital or dentist, when you're admitted. For more information, call the Overseas Healthcare Team on 0191 218 1999 (Monday to Friday, 8am to 5pm).

EU Directive
You should contact your local PCT. They can tell you how to apply and whether you will need prior authorisation for a particular treatment.

Limit to funding and reimbursements

S2
There is no limit to how much can be paid to the treating institution, even if the cost is more than the treatment would have been under the NHS. However, some countries require a patient contribution, which you would have to pay up front.

EU Directive
You’ll have to pay the cost up front and seek reimbursement when you're back in the UK. However, you can only claim back as much as the treatment would have cost in the UK. If the treatment is more expensive, you’ll have to provide the additional costs. If the treatment was cheaper than under the NHS, you will not be able to profit from it and ask for the difference in return from the NHS.

Comments

4 Comments about ‘Compare application routes’

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Comments are personal views. Any information they give has not been checked and may not be accurate.

simonzldn said on 27 September 2011

I had had a Hip Operation in a clinic in Tunisia. I was on the NHS Hip Surgery list for years ..while on holidays in Tunisia, things got worse and I had to see a Doctor there...I was offered an emergency surgery. I took the chance and did it. Plus, I had to stay for a further rehabilitation process that lasted nearly 3/4 weeks before I was flown back to the UK on a wheelchair of course. I paid for all the medical and rehabilitiation fees theremyself (around £6.000 to 8.000 in total). I was never told If of these NHS refunding courses by my GP on my return. Was I entitled to claim for a reimbursement of all or part of these medical costs. Could anyone help or assist on this matter...?

Thank you...I am Brain Injuries Survivor and could hardly deal with my personal daily affairs then. I have since improved (Memory function wise) thanks to the support of Headway House Association who provides me with regular support and other medical and physiotherapy and psychotherapy care.

I will appreciate if someone could enlighten me on these Medical Costs and Reimbursements matter.

Simonzldn

hartley said on 06 November 2010

Do patients need to have arranged treatment abroad before leaving the UK, so that they can claim under Article 56?

Rob Dickman DH said on 11 June 2010

The Article 56 route is the subject of Regulations, Secretary of State's Directions and Guidance which were released to the NHS last month. Link:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_115256

In some cases, prior authorisation may be required before a patient accesses treatment in another EEA State. However, PCTs cannot insist on a patient obtaining prior authorisation where this is not justified (the regulations set out the circumstances where prior authorisation may be applied). Hence, there may well be occasions where patients return from an EEA country where they have incurred treatment costs and then seek to claim reimbursement from the PCT - less any applicable NHS charges. The principal considerations are whether there is a proven clinical need for the treatment and whether the patient would have been entitled to the same or similar treatment on the NHS.

WorcsCommissioner said on 26 May 2010

Can you please confirm whether patients wishing to receive re-imbursement using the Article 56 route, need to have had this decision considered and endorsed by a UK (local) clinician in charge of the person's ongoing care?

Our main concern is that patients may go into the EU to receive surgery which their local PCT does not support. The result being that the patient, if not informed of this before the decision to travel for treatment is made, then runs the risk of not being funded for that treatment.