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The EU Directive route

Before the UK left the EU, the EU Directive allowed people to have treatments in another European Economic Area (EEA) country (but not Switzerland) and apply for reimbursement of the cost.

The EU Directive route covered state-funded and private planned care and emergency treatment. Planned care included routine and specialised treatments, but specialised treatments needed approval first.

If you had any treatment, you could apply for reimbursement, up to the cost of the same or equivalent treatment in your home healthcare system.

Now that the UK has left the EU, the EU Directive route has ended in the UK. However, there are some legacy arrangements.

If you had treatment (which you have paid for) or submitted a funding application for specialised treatment, you will only be eligible for reimbursement if:

  • treatment started or was completed before 31 December 2020, exit day (and prior approval was not needed, as it was not a specialised treatment)
  • you submitted a funding application for specialised treatment before 31 December 2020, but did not get the decision before 31 December 2020
  • you submitted a funding application for specialised treatment that was approved before 31 December 2020, but the treatment had not started before 31 December 2020 (that is, you had prior approval)

Treatment after 31 December 2021 (the end of the transition period) will not be reimbursed, unless there are exceptional circumstances (such as delays due to COVID-19). Each case will be considered individually.

Read the list of specialised treatments on the NHS England website

Submit your claim for funding as soon as possible to avoid delays. However, valid claims will still be reviewed and paid if they’re received within 6 years of when you had the treatment.

What you can claim for

You're only entitled to funding for treatments that are the same as or equivalent to those available to you on the NHS.

If you’re eligible for reimbursement, you will only be funded up to the cost of equivalent treatment on the NHS, in line with the NHS tariff. You may not get the full amount back. For example, if you pay prescription charges in the UK you will not receive a refund for prescription costs as part of the reimbursement.

The EU Directive and legacy arrangements only cover treatment costs.

What you cannot claim back

You cannot claim money back for:

  • any additional costs you may have such as a private room or facilities
  • travel or accommodation costs
  • repatriation costs
  • translation costs

Apply for approval or reimbursement

When you apply for money back, make sure you:

You must complete the form in full and provide details of the type of treatment and the healthcare provider, including:

  • your National Insurance or NHS Number
  • admission and discharge dates
  • original receipts and proof of payment
  • English translations of any receipts and supporting documents that are in a different language

How to send your application

Send all your supporting documents by email (apart from proof of payment documents which need to be original versions and posted) as this is quicker to process. This includes:

  • your completed application form
  • proof of residence
  • medical documents

If your supporting documents are in a different language, you will need to provide an English translation. Translations do not have to be done by an official translator.

Read the EU Ddirective funding applications guidance notes for more information (PDF, 176kb)

Scan your documents and email them as PDF attachments to the European Cross Border Healthcare Team.


If you’re unable to apply by email, post your completed form and supporting documents to the address below. Postal applications may take longer to be processed.

If you're using a mobile phone, you can make PDF versions of documents by either:

  • using your phone camera's scan setting
  • selecting "print" after you've taken a picture of the document, then save it as a PDF

Where possible, organise documents into one PDF for each category. For example, an application form PDF, proofs of residence as one PDF, medical documentation as one PDF.

Send all PDF documents together in one email.

Do not email embedded documents or photographs (jpg/jpeg files).

Once the European Cross Border Healthcare Team has received your application, you’ll be given an EU reference number. Include this whenever you contact the team.

Send your original paper receipts and paper invoices by post to:

European Cross Border Healthcare Team
NHS England
County Hall
Leicester Road

Make sure you include your EU reference number with your paper documents.

How long it takes

It can take up to 20 working days to process an application and decide if you're eligible for reimbursement. It may take longer if the application is incomplete and you're asked for more information.

Request a review or appeal

If you're unhappy with the outcome of your application, you can request a review or an appeal.

Request a review of the decision if you have additional information or evidence that was not provided as part of the original application and you believe it may affect the rejection decision.

Request a formal appeal if you do not agree with the rejection decision, but do not have any additional information or evidence.

Email NHS England on and quote the reference number included with the application outcome.

Concerns and complaints

Raise a concern

If you're unhappy with the review or appeal outcome, you can also raise a concern with the European Cross Border Healthcare team directly, or you can email NHS England on

You can do this for example if you do not agree with a decision or you've had a problem with the processing of your application, such as an inappropriate delay.

Raise a complaint

You can also raise a complaint with the NHS England Customer Contact Centre if you want to complain about something, for example:

  • a process not being followed
  • concerns about how your application was handles due to communication issues or the behaviour or attitude of the team or team members
  • a policy issue in relation to your application

You cannot complain about the decision or outcome of the application. This would be considered as a review, appeal or concern and will be referred.

Page last reviewed: 16 January 2024
Next review due: 16 January 2027