The Need for Prior Authorisation

As an EU citizen, you have the right to receive medical treatment in another EU/EEA country.

This can happen either with or without prior authorisation, depending on the type of treatment and the legal framework you choose to apply under. The procedure and reimbursement rules differ in each case.

When Is Prior Authorisation Required?

Prior authorisation is required when:

• • You seek treatment abroad under the Social Security Regulations (Regulations (EC) 883/2004 and 987/2009).

• • The treatment involves hospitalisation, highly specialised or cost-intensive procedures, or poses risks to patient or public safety, even under the Directive 2011/24/EU.

In general:

• • Under the Social Security Regulations: Authorisation is always required for planned treatment. You must obtain an S2 form before receiving care.

• • Under the Directive 2011/24/EU: Most treatments do not require prior authorisation, but Member States may impose it for specific treatments involving overnight hospital stays or significant costs.

How to Obtain Prior Authorisation

To request prior authorisation:

1. 1. Contact your national health service or statutory health insurance provider.

1. 1. Submit a request detailing:
      • • The treatment you wish to receive.
      • • The healthcare provider and country.
      • • Medical justification, if needed.

1. 1. If granted, you’ll receive the S2 form (under the Social Security Regulations) or written approval (under the Directive).

1. 1. This approval guarantees that your treatment costs will be covered, either fully or partially.

Authorisation must not be refused if:

• • The treatment is covered in your home country.

• • It cannot be provided in a medically justifiable time frame at home.

When You Receive Treatment with Prior Authorisation

If you receive treatment with prior authorisation:

• • Under the Social Security Regulations:
    • • You’re treated as if insured in the country of treatment.
    • • Costs are covered directly (third-party payment), or reimbursed according to the tariffs of the country where you receive care.
    • • You may also be reimbursed for travel and accommodation, if these would be covered at home.

• • Under Directive 2011/24/EU (if authorisation was required and granted):
    • • You must pay upfront.
    • • You’ll be reimbursed according to your home country’s tariffs, even if actual costs abroad are higher.

When You Receive Treatment Without Prior Authorisation

You may also receive treatment without authorisation if:

• • You use the Directive 2011/24/EU route and the treatment is not subject to the prior authorisation requirement.

• • The treatment is covered in your home country’s public healthcare system.

In this case:

• • You must pay all costs yourself upfront.

• • On return, you can request reimbursement from your national health service.

• • Reimbursement is limited to what your treatment would have cost at home.

Be aware:

• • If the treatment is more expensive abroad, you will bear the additional cost.

• • Private healthcare providers abroad are also eligible under the Directive, offering more flexibility.

Key Differences: With vs Without Authorisation

Important to Know

• • Always confirm in advance whether your treatment requires prior authorisation.

• • Check if the healthcare provider is recognised under the national system (especially under the Social Security Regulations).

• • Contact your National Contact Point for personalised guidance.

Last updated on 28 May 2025