The European Union (EU) Directive on ‘cross border health care’ gives UK patients the legal right to health care services in another European country provided the treatment is medically necessary and is available under the NHS.
Patients can also have treatment Europe if their equivalent NHS treatment is not available in the UK within a ‘medically acceptable’ time period.
The following countries are part of this legal arrangement:
Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the United Kingdom.
What type of “health care” is covered?
Only treatment that is planned in advance is covered by this arrangement.
The only ‘planned’ health care that is not included in this arrangement is maternity care. For information about entitlement to maternity care/giving birth in Europe, see Information regarding maternity care and giving birth in Europe below.
Emergency treatment in Europe is covered by a separate arrangement. UK citizens travelling in Europe should obtain a European Health Insurance Card (EHIC) to ensure they can be reimbursed for the cost of any emergency health care needed when abroad.
EHIC is entirely FREE to obtain through the following website, which also provides detailed information about the scheme: NHS Choices – EHIC – European Health Insurance Card.
BEWARE Unofficial websites may charge for EHIC if applications are made through them.
Who is entitled to NHS funding for planned healthcare in Europe?
To be eligible for NHS-funded treatment in Europe, patients must be:
- Resident in the UK.
- Entitled to NHS services.
- The patient’s General Practitioner (GP), or other NHS doctor, must recommend the treatment.
- The patient must be eligible for the treatment under the NHS. National or local policies may restrict access to some treatments
- For information about national funding policies, see NHS England’s website.
NB: If a patient (and with the support of their doctor) wants to be treated in Europe with a treatment not normally provided by their local NHS, then the patient and their doctor must seek prior approval by applying through the Individual Funding Request process: bucks.IFRrequests@nhs.net.
- The cost of treatment in Europe must be the same as, or less than, the cost of NHS treatment. (In some circumstances, patients may be required to pay any cost difference themselves).
Payment for treatment in Europe
Depending on the treatment required, patients may have to pay the European hospital (or other treatment provider) at the time treatment. Patients will then apply for their money back on their return to the UK. In some situations, however:
- prior authorisation must be obtained from the NHS
- the cost of the treatment in Europe (or a proportion of it) will be paid directly by NHS England.
It is important that patients check in advance whether prior approval is required, and who will be responsible for paying for healthcare in Europe. If patients don’t follow the correct procedures, they may end up being responsible for the full cost of treatment. See the Further Information section below.
How to apply for planned healthcare in Europe
For NHS treatment in Europe, patients – with the help and advice of their doctor – should complete NHS England’s application form.
Please note – it can take NHS England up to 20 working days to process an application and a decision to be made. This may take longer if applications are not complete and additional information has to be requested. If approved, reimbursement can take up to a further 30 working days to be processed.
For all general enquiries relating to healthcare in Europe, please contact NHS England on 0300 311 22 33 or email email@example.com.
For specific questions on the progress of your application for planned treatment in Europe, please contact the European Team on 0116 295 0877 or email firstname.lastname@example.org .
For questions about the EHIC, please contact the Overseas Healthcare Team on 0191 218 1999 or email@example.com.
For questions about the refunding of co-payments, please contact the Overseas Healthcare Team on 0191 218 1999 or firstname.lastname@example.org.
Information regarding maternity care and giving birth in Europe
If you want to give birth in any of the following countries:
Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France , Germany , Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, or you will need:
- A valid European Health Insurance Care (EHIC) to cover you for routine medical care
- An S2 (or E112) form to cover the birth itself
- European Health Insurance Card (EHIC)
For information on how to apply for a FREE EHIC, see above.
However, it is recommended that you have adequate travel insurance, as the EHIC may not cover you for every situation.
In addition, even if you are planning to give birth in the UK and you’re only going to Europe for a short holiday or other visit, you are strongly advised to take a valid EHIC with you. The card will provide cover for all medical treatment linked to the birth if the baby is born unexpectedly.
- S2 (or E112) Form
To apply for an S2 for maternity care, you need to write to the Overseas Healthcare Team explaining why you want care outside the UK and enclosing the following information:
- a maternity certificate (MATB1) or a letter from your UK GP or midwife showing your expected date of delivery
- your NHS number or National Insurance number
- your date of birth, your full UK address and dates of travel
- explain whether you will be returning to the UK after you have given birth
- state whether you have already left the UK for the other country.
The address to send your application to is:
Department for Work and Pensions
Overseas Healthcare Team
Post Handling Site A
For questions about maternity care or giving birth in Europe, please contact the Overseas Healthcare Team on 0191 218 1999 or email@example.com.
General information is also available from NHS Choices – Giving birth outside the UK.