Did you know that if you’re an EU citizen, you have the right to the same medical treatment in any member state as you do at home? The European Commission’s Directive on Patients’ Rights in Cross-border Healthcare sets up a system to empower EU patients to use their health benefits in any member state they find themselves in, and even plan surgery in member states under certain conditions.
We created this handy step-by-step guide to getting care through the Directive and how you can find more information.
Step 1: Do Your Research!
With any major medical procedure, whether at home or abroad, knowledge is power. Use Make Medical Trip’s search platform to look through some of our medical tourism destination profiles and find a country and treatment that matches your needs and budget. Our Patient Care Team is always available to help by phone or email. If nothing else, you’ll feel a little more comfortable when some of your questions are answered.
Also, under the Directive you have the right to a copy of your medical records. Make sure you get a copy from your health authority at home and bring it with you abroad or have it sent to the clinic where you’ll be treated.
Step 1.5: Get Prior Authorization
In some cases, you’ll need to get a prior authorization. The Directive was designed to make these cases fairly rare, so this isn’t something you should have to do often. Your National Point of Contact can help you find out whether you need it and guide you through the process, and it’s a good idea to check whether you think you need it or not. For UK patients, NHS also facilitates this process. You should receive a form called an S2 form when you’re approved.
You may need prior authorization:
- For procedures that will require you to stay for one or more nights in the hospital
- For highly-specialized or extremely expensive procedures
- If there is a serious question about the safety or quality of the clinic you want to receive care from
If your application is denied, there must be a valid explanation for it and your National Point of Contact can help you appeal the decision. You may be denied if the treatment is available in a reasonable amount of time in your home country, or if there is significant concern about the quality or safety of the clinic you want to visit, or if you are not entitled to the treatment at home.
Step 2: Have The Procedure Done
Patients will usually need to pay up-front for care. Some public and private insurance providers might choose to pay directly ahead of time, but in most cases you’ll have to cover your expenses up-front and apply to be reimbursed. To have your insurance pay directly, apply for prior authorization (whether you necessarily need to or not) and obtain an S2 form. Make sure you collect all of your relevant documents and request a copy of your medical record from the clinic you visit. Remember that you have the same rights as any other patient and you are entitled to the same treatment as a local citizen.
Step 3: Apply For Reimbursement
If you visited a public healthcare facility
You likely had to pay up-front, and you can apply for reimbursement from the authorities in the country you visited and be reimbursed at the same rate as a local. You can also apply to be reimbursed by your insurance. If your insurance would pay more than the authorities, you can apply for your insurance company to pay you the difference.
If you visited a private clinic
You should pay up-front and apply to your insurance company to be reimbursed. In this case, you will be reimbursed up to the full cost of the treatment. You will only be reimbursed if you received a treatment you’re entitled to under your plan. It is possible that if you receive care from a private clinic that you will have to pay some of the cost.
Step 4: Follow-up Care
Your home health care system is responsible for providing you with the same follow-up care you would receive if you had the procedure done at home.
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MakeMedicalTrip.com makes medical travel easy by connecting patients with clinics, hospitals, and medical tourism agencies worldwide, completely free of charge. We have clinics specializing in everything from dentistry to bariatrics. Lean more about how Make Medical Trip works at www.makemedicaltrip.com/how-we-help-you/