Going abroad for medical treatment

If you’re thinking about having medical treatment in another European country, it’s important to understand how it works and the risks involved. If you don’t follow the correct procedures, you may end up being responsible for the full cost of treatment yourself.

For example, your European Health Insurance Card (EHIC) or UK Global Health Insurance Card (GHIC) does not cover going abroad for medical treatment. The EHIC and GHIC is for necessary healthcare treatment while you’re abroad. (Please note your card must be in date to be valid). Necessary healthcare refers to healthcare that becomes medically necessary during your stay, and you cannot reasonably wait until you’re back in the UK to get it.

You should also ensure you have adequate travel insurance.


UK-funded treatment in Europe from 1 January 2021

The UK has left the EU and access to treatment in Europe has changed.

Under the European Union Directive on patients’ rights in cross-border healthcare, patients are entitled to travel to a European Economic Area (EEA) country to purchase treatment.

If the treatment is medically necessary and the same as, or equivalent to, a service that they would be eligible to receive under the NHS, they can apply to NHS Devon for prior approval. This is in order to ensure equity of treatment for all our residents. Reimbursement will not be authorised without prior approval.

The Directive covers UK patients choosing to be treated in another EEA country. This does not cover patients in England choosing to access treatment in Scotland, Wales or Northern Ireland.

The criteria vary depending on the access route. There are 2 possible routes:

  • S2 scheme, formerly called E112
  • EU Cross Border Healthcare Directive
The S2 (planned treatment) route

This is a direct funding arrangement between the NHS and the state healthcare provider in the country of your choice. In many cases, you will not be required to pay anything towards the cost of your treatment, although some countries may require you to pay a proportion of the costs. If you wish to use this route you must apply for – and be granted – authorisation of your treatment from NHS England before receiving treatment before you travel.

Eligibility criteria

In order to approve your S2 application, NHS England will need to be satisfied that the following eligibility criteria are met:

  • You’re ordinarily resident in England and entitled to treatment on the NHS.
  • The requested treatment would normally be provided on the NHS to an individual in your circumstances.
  • You’ve provided written evidence that you have had a full clinical assessment by a clinician in either the UK, any EEA country, or Switzerland. The clinician’s statement must clearly state why the treatment you seek is needed in your circumstances, and what the clinician considers to be a medically justifiable time period within which you should be treated again, based on your circumstances. The clinician should support this statement by giving objective reasons.
  • The requested treatment is available under the treating country’s state healthcare scheme.
  • Taking into consideration the information provided by the clinician, NHS England has determined that the same or equivalent treatment cannot be provided to you on the NHS within a time period that’s medically justifiable.
  • The requested treatment is not experimental or part of a drug trial.
  • The requested treatment is not emergency treatment.
  • If you’re applying for an S2 for treatment in Switzerland, that you’ve satisfied the nationality criteria by providing proof of your UK, Swiss or EU nationality, or your status as a refugee or stateless person, or your status as a dependant of someone with one of those nationalities or statuses.

For more information on the S2 route, please visit the NHS website.

The EU directive on cross-border healthcare: the EU directive route

This is a funding arrangement between you and the NHS. Generally, using this route means you will have to pay the costs of your treatment abroad upfront and then claim reimbursement of eligible costs from the NHS when you return.

You can only apply for reimbursement for treatment that started or was approved before 11pm on 31 December 2020.

For more information on the EU directive route, please visit the NHS Website.


Where to start

If you’re planning to have treatment abroad it’s important to discuss your plans with your GP before making any final decisions about travel or medical arrangements.

Other than in exceptional circumstances, you will need to apply for authorisation prior to treatment if:

  • you are seeking funding via the S2 route, or
  • you are seeking funding via the EU Directive route and the treatment for which you are seeking funding requires prior authorisation.

If you are still not sure whether prior authorisation is required, contact NHS England by emailing england.europeanhealthcare@nhs.net.

Although applying for funding prior to treatment is not mandatory for all treatment abroad, we do recommend that you contact NHS England or apply for funding before treatment in all cases. This will enable NHS England to confirm your eligibility and the funding or reimbursement process.

Do your research

Going for medical treatment abroad is not easy and a GP or NHS England can only do so much to help you.

You’ll have to make the arrangements yourself, including finding a healthcare provider and making all the travel arrangements.

This means it’s important to do some research and gather enough information to make an informed choice.

You should consider:

  • any language barriers
  • whether you know enough about the people who’ll treat you and the facilities available
  • communication between medical staff abroad and in the UK, such as exchanging medical records and arranging aftercare back home
  • how to make a complaint if things go wrong – the NHS is not liable for negligence or failure of treatment

You’ll need to be aware of how your aftercare will be provided when you return home and understand the conditions under which you’ll be treated abroad.

You should also ensure you have adequate insurance. Most travel insurance policies will not cover you for planned treatment abroad, so you may need specialist cover.

Going outside Europe for treatment

Neither the S2 route nor the EU directive route applies to treatment outside Europe.

If you want to have treatment in a non-European country, such as in Canada or the US, speak to your local integrated care board (ICB).

Information taken from the NHS Website & the One Devon website.