Skip to main content

Compare funding routes

If you wish to travel to Europe for medical treatment, you should be aware of the key differences between the S2 and the EU directive funding routes.

On this page you can compare the 2 routes by looking at the differences in:

  • payment conditions
  • treating sector
  • application process
  • limit to funding and reimbursements

Payment conditions

S2 route

The NHS 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. However, you may be able to claim back some or all of the co-payment when you return to the UK.

EU directive

You will normally have to pay treatment costs upfront and get reimbursement from NHS England. Reimbursement will be limited to the cost of the same treatment under the NHS.

Treating sector

S2 route

Since this is through a direct arrangement between the NHS and the state health service provider, 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 route

Fill in the application form (PDF, 105kb) and send it to NHS England. To avoid any difficulty, you should read the application guidance notes (PDF, 80kb). Please ensure that you use the latest form, as provided on this site, to submit your application. If you use an outdated form you may be asked to supply further information or resubmit the application.

Once NHS England has received your application form, it will decide whether or not you are eligible for funding via this route. If you are, you will be issued with an approved S2 form, which you will need to present to the health service provider abroad when you're admitted. For more information, contact NHS England

EU directive

Again, fill in the application form provided (PDF, 105kb) and send it to NHS England. To avoid any difficulty, you should read the application guidance notes (PDF, 80kb). If you are considering going abroad and claiming reimbursement following treatment, we recommend that you contact NHS England to confirm your eligibility.

Some services are subject to prior authorisation and you will therefore be required to apply for funding before receiving treatment. Learn what types of services require prior authorisation (PDF, 72Kb). Please note that this is not necessarily a definitive list.

Limit to funding and reimbursements

S2 route

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 will 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 on the NHS. If the treatment is more expensive, you'll have to cover the additional costs. If the treatment was cheaper than under the NHS, the NHS will not refund the difference.

Important contacts in England

For all general enquiries relating to healthcare in another EEA country or accessing NHS treatment within England, contact NHS England on 0300 311 2233 or

For specific questions on the progress of your application for planned treatment in another EEA country, contact the European Team on 0113 824 9653 or

For questions on giving birth abroad, refunds of co-payments, or about the EHIC, contact Overseas Healthcare Services on 0191 218 1999 or

Contact details for other EEA countries

Each EEA country is required to provide information on their health services for residents from other EEA countries through a national contact point.

See our country-by-country guide if you require information about healthcare in another EEA country.

Page last reviewed: 13 February 2019
Next review due: 13 February 2022