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Seeking medical treatment in Europe

What to do before going abroad for medical treatment

If you're thinking about having medical treatment abroad, it's important to understand how it works and the risks involved. If you don't follow the correct procedures, you may end up being responsible for the full cost of treatment.

For example, your European Health Insurance Card (EHIC) does not cover going abroad for medical treatment. The EHIC is for emergency treatment that becomes necessary while you're abroad. Find out more about what the EHIC covers. 

As an NHS patient, you have the right to receive treatment anywhere in the European Economic Area (EEA). However, conditions may apply in some cases. Read about entitlements to treatment abroad.

There are two ways to access NHS-funded healthcare in other EEA countries:

  1. The S2 route (or E112)
    This is a direct arrangement between the NHS and the state healthcare provider in the country of your choice. Prior approval is required.
  2. The EU Directive on cross-border healthcare (or Article 56)
    Generally, you’ll have to pay the costs of treatment abroad and then claim reimbursement from the NHS when you return. Depending on the treatment, it may be necessary for you to obtain authorisation from NHS England, the commissioning board, before receiving treatment. Find out what types of services requiring prior authorisation (PDF, 72 kb).

Each option works in a slightly different way. Read a detailed description the S2 route and EU Directive on cross-border healthcare.

Where to start

If you're planning to have treatment abroad, it's important to discuss your plans with your doctor before making any final decisions about travel or medical arrangements.

You will need to apply for funding prior to treatment if:

  • you are seeking funding via the S2 route
  • or the treatment for which you are seeking funding is subject to prior authorisation. Find out what types of services requiring prior authorisation (PDF, 72 kb).

If you are still not sure that prior authorisation is required, contact NHS England, the commissioning board, by emailing nhscb.europeanhealthcare@nhs.net.

TipAlthough applying for funding prior to treatment is not mandatory for other requests, we do recommend that you contact NHS England or apply for funding before treatment in all cases. This will enable NHS England to confirm your eligibility and the funding or reimbursement process. 

You'll need to be aware of how your aftercare will be provided when you return home and understand the conditions under which you will be treated abroad.

Tip

You should also ensure that you have adequate insurance. Most travel insurance policies will not cover you for planned treatment abroad, so you may need specialist cover.

Do your research

Going for medical treatment abroad isn't easy and your GP or NHS England, the commissioing board, can only do so much to help you. You will have to make most of the arrangements yourself, including finding a healthcare provider and all the travel arrangements.

Therefore, it's important to do some research and gather enough information to make an informed choice. You should consider:

  • any language barriers
  • whether you know enough about the people who will treat you and the facilities
  • communication between medical staff abroad and the UK, such as exchanging medical records and arranging aftercare back home
  • how to make a complaint if things go wrong (the NHS is not liable for negligence or failure of treatment)

TipRead about the risks of going abroad for treatment for further tips and advice.

What is the EEA?

The European Economic Area (EEA) is a free trade zone between countries of the European Union (EU), Iceland, Norway and Liechtenstein. Your EHIC will also cover you for healthcare that becomes necessary during a trip to Switzerland. However, if want to go to Switzerland for treatment, you should contact NHS England, the commissioning board, to check if NHS-funded treatment is possible.

How to contact a local health commissioner

  • In England, contact NHS England, the commissioning board.
  • In Wales, contact your local health board or the Health Commission Wales.
  • In Scotland, contact your local NHS board.
  • In Northern Ireland, contact the health and social services board.

Going outside Europe for treatment

The right to seek NHS-funded medical care does not extend beyond Europe.

However, if you want to have treatment outside Europe, such as in Canada or the USA, speak to your local health commissioner about an individual funding request (IFR). It is up to the commissioner to decide whether you can get treatment outside Europe. If this is something you want to do, contact NHS England, the commissioning board, for more information.

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

ponyandtrap said on 28 November 2012

I've just moved to Switzerland (been there for 3 months) but have just returned to the UK to have my baby. I was receiving consultant care in the UK prior to the move and continue to do so now I'm back.

Am I liable to pay for any maternity services I receive here during my stay. Although I do have private medical cover in Switzerland, there are no private maternity units in my area so I am reliant on NHS treatment. I intend to go back to Switzerland in due course after the birth.

I was resident in the UK for 30+ years prior to our move.

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michaelnewport said on 28 June 2012

How do I reclaim for my doctors visits in Belgium...I tried ringing the helpline as suggested but gave up after 10 minutes.

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RobinM said on 23 October 2011

Dear Alex
There's no such thing as an S1 card.
Once you've a (permnt) addr in another EU country, you can apply to Newcastle for an S1 form. You'll get one if you satisfy criteria: you're above retirement age, or meet early retirement criteria.
I am pretty sure that signing on does not auto get you an S1.
Armed with this form, & plethora of other paperwork, you can then present yourself to your new country's health service office with the intention of gettin into their health system.
The S1 form is useless in a doctor's surgery or at a pharmacist.

Your EHIC cards are yr safety net & will cover you till they expire (expiry date is printed thereon). Once they expire, Newcastle will tell you what to do next, or tell you they can't advise you in which case, you are on your own health cost wise.

Otherwise, having inserted S1 + paperwork into local office, you might then get accepted into your new country's health system but even then it will be subject to any prevailing agreement between Newcastle & your new country. It varies across all EU countries. Don't expect a country with lean medicare system & no significant agrment with UK to treat you free.

If you've a prevailing medical condition in UK that requires on-going treatment (hence costs) then I urge you to check with Newcastle before you leave, what will happen when you tip up in your new country.

Assume nothing.

Basically, most countries will look after you health-wise provided you have entered into a social contract with them or a partner country. I mean, if you've paid NI in UK (recently!) then UK is 1st point of call.
If you haven't been working in UK for a few years and don't intend to work in new country, then if you are below retirement age, expect to pay for your healthcare out of your private means.

My tip

• Don't assume you won't be ill in yr new country.
• Don't assume someone else will pay if you are.
• If Newcastle disagree with me, Newcastle is right.

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AlbusDumbledore said on 16 September 2011

For any treatment coverage and costs use this link

http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/Pages/EEAcountries.aspx

basically its just the country to country guide it shows all the countries which are covered under the Healthcare Scheme.

Once on, click on the country your visiting and it explains treatment coverages and costs.

Please not the EHIC is not valid for planned treatment.

It will cover any pre-existing illnesses or conditions so for the diabetes yes you will be covered should you require any treatment.

prescription prices may vary and should you go for a check up at the doctors you will be charged on the same basis as a Swedish resident. Charges are not refundable and vary between SEK 100 to SE 150 (£8-£12) per treatment

Hope This Helps!

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Linda52 said on 06 August 2011

I plan to live in Sweden for a number of years. I am diabetic and would like to know what costs would be involved in medical check ups and prescriptions.

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Alex Plypin said on 17 June 2011

I plan to emigrate to Bulgaria, with my family and we all have EHIC cards. We have been advised that we also need an S1 card, but can only apply for this if we are on benefits - which we are not. My wife and I do not qualify for our state pensions for some time, although we both receive small private pensions - and she has taken early retirement.

Is it absolutely essential to sign on, in order to be even able to apply for an S1 card?

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fortune100 said on 23 March 2011

I would like to know if rehabilitation treatment is covered by either article 56 or S2. If traumatic rehabilitation were required, would it fall under "planned treatment"?

Also, what is the coverage for Switzerland? From what I understand it could be possible to receive treatment, but this would only be with prior authorisation of hospital treatment. Non-hospital treatment would not be covered. Does this mean rehabilitation is not covered, be it state-sector or private?

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Last reviewed: 08/03/2013

Next review due: 08/03/2015

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