You wish to receive treatment in another European State and you want to know if the costs will be met. To find out whether you meet the conditions, you need to consider the following questions:
In which country do you have health insurance?
The rules explained here apply if you are covered by a statutory social security scheme in a member State of the European Economic Area (EEA) or Switzerland (except for treatment without authorisation in the case of Switzerland).
Where are you planning to get treatment?
The rules explained here apply to treatment received in a member State of the European Economic Area (EEA) or Switzerland (except for treatment without authorisation in the case of Switzerland).
Is this treatment unforeseen?
If so, it is covered by the European Health Insurance Card. If you unexpectedly need treatment while travelling in an EEA Member State or Switzerland (i.e. getting treatment was not the purpose of your journey), your European Health Insurance Card ensures that the cost of your treatment is covered.
Is this treatment covered by the legislation of the state where you have your health insurance?
In principle, your treatment costs will be covered only if the law in the country where you are insured recognises the treatment. For example, the cost of spa cures is covered in some countries but not in others. Find out from your insurance institution before you travel.
Is it hospital treatment?
There is currently no European definition of "hospital treatment" or "non-hospital treatment". If in doubt, check with your health insurance institution.
If this is not unforeseen treatment, ie the treatment concerned is planned and your reason for travelling abroad, there are two possible scenarios: treatment in hospital and non-hospital treatment.
In the case of hospital treatment, your health insurance institution will almost always require you to seek authorisation. The cost will then be covered under the terms of the country where you receive the treatment (country of treatment). If those terms are less favourable than the terms offered by your own health insurance, the difference will be refunded to you. If you have not received authorisation, then your treatment costs will not automatically be covered. You can still claim reimbursement on your return, but there are no guarantees that your claim will be accepted.
In the case of non-hospital treatment, you can also seek authorisation before you leave, and will then benefit from the same guarantees. You can also dispense with authorisation and travel directly to the country where you wish to receive treatment (country of treatment) and claim for reimbursement on your return. The cost of your treatment will then be covered under the terms of the State where your health insurance institution is based. Please note that this option is not recognised in the case of Switzerland.
If you fulfil these conditions and wish to obtain an S2 form, or if you want to obtain more information, please contact your health insurance institution.
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