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Seeking medical treatment in Europe

What is the S2 route?

The S2 (formerly E112) route entitles you to state-funded treatment in another European Economic Area (EEA) country or Switzerland.

Treatment will be provided under the same conditions of care and payment as for residents of that country. This could mean you have to pay a percentage of the costs personally.

For example, in some countries, patients cover 25% of the costs of their state-provided treatment. The state covers the other 75%. This is known as a co-payment charge. 

If you receive treatment under this healthcare system, you are expected to pay the same co-payment charge as a patient from that country. For example, for an operation that costs £8,000 of which you're expected to pay a standard patient co-payment charge of 25%, you will pay £2,000. The state will pay the remaining £6,000.

However, you may be able to claim back some or all of the co-payment when you return to the UK. To apply for a refund of the co-payment, you will need to contact the Overseas Healthcare Team on 0191 218 1999 or

In some countries, care is completely free, as in the UK. This means the S2 will cover 100% of the costs of your care, so you would not be required to pay any treatment costs upfront. 

Note: Treatment covered by an S2 cannot be experimental or a drug trial.

How to apply

To be issued with an S2 form, you will need to apply for funding (PDF, 102kb) prior to treatment. Please ensure you are using the latest available form (as provided on this site) before submitting your application. Applicants using an outdated form may be asked to supply further information or resubmit their application.

NHS England will decide whether or not to approve your application and will need to be satisfied that:

  • an NHS consultant has recommended in writing that you be treated in the other EEA country, and a full clinical assessment has been carried out to show the treatment will meet your specific needs
  • the costs of sending you abroad for treatment are justified – the health commissioner is responsible for spending money efficiently and fairly in the interests of all the patients they look after
  • the treatment is available under the other country's state health scheme
  • you're entitled to treatment under the NHS

If NHS England approves your application, you will be issued with an S2 form. You will need to take this form with you to the member state where you will be receiving treatment. For more information, contact NHS England.


S2s to cover maternity care in another EEA country are processed differently. For more information, see our section Giving birth outside the UK.


The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

CrazyG said on 17 June 2014

After returning from holiday on 13th June 2014, and also having to receive treatment from a doctor to enable me to travel I decided to make a call to try and claim a refund under the European Health Card. I have just made a phone call to the relevant department, without even gathering details I was told by a rather abrupt person "if you were not treated by a state doctor you cannot claim". I was unfit to go to a hospital at the time we called the doctor and if it hadn't been for the doctor I would have ended up in hospital anyway. So please tell me and the rest of the UK what was I supposed to do? Unfit to get to a state hospital (although i am pretty sure the doctor that treated me was from one anyway), not travel back to the UK, please tell me as I am interested. When I asked this person the question the answer was clearly read from a script. I have a doctors note, the chemist bills etc and will be pursuing a refund regardless

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campogirl said on 23 May 2013

I am living in Spain and as a pensioner I am registered for Spanish health care. I need to come to England for a follow up cancer review following treatment I received while in England, and believe I need a S2, Can I get it from England or do I need to get it in Spain.

The web site I have looked at seems to talk about going abroad for health treatment. How do I do the opposite?

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anobium said on 02 November 2012

Can anyone advise re form S1, that is how to apply etc. I have a UK address but spend most of my time abroad. The EHIC card is apparently not the same as the S1 but I have not been able to get info.

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Page last reviewed: 11/09/2015

Next review due: 11/09/2017

S2 eligibility criteria

To be eligible for the S2 route, you must:

  • be ordinarily resident in England
  • be receiving treatment in the state sector
  • be able to prove the hospital will accept an S2 
  • provide a letter of support from your consultant in the UK
  • provide an estimation of cost
  • provide the proposed dates of treatment 


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