Cross-border healthcare

On 9 March 2011, the directive 2011/24/EU on the application of patients’ rights in cross-border healthcare was officially signed by the European Parliament and the Council.

Update: Dec 2013

Why is the EU Directive concerning patients’ rights required?

  1. To define clearly the reimbursement conditions for the healthcare services in other EU member states
  2. To guarantee the quality and security of cross-border care
  3. To contribute to the cooperation between the national healthcare systems and ultimately, to save money

End of legal uncertainty concerning cost-takeovers of healthcare services

This legal text is very important, since it settles patients’ rights in Europe. Therefore, the same right for all the EU citizens is in force, no matter if the patient comes from Germany, Rumania or Spain. Before, the applicable right in case of cross-border healthcare was complex and hard to understand: the jurisdiction of the European Court of Justice and the national regulations juxtaposed, and even specialized jurists had difficulty in finding their way. One had put an end to this, and the rules of the game will be clear and standardized.

No prior authorization is necessary for planned ambulatory care anymore

This legal text confirms that it is possible for all the European citizens to use outpatient medical services in another member state (for instance dental treatment, visit to the optician or general practitioner), without prior authorization of their health insurance fund. The cost-takeovers will be settled depending on the rates and the regulation in force in the patient’s country.

To avoid a two-speed medicine and to enable a treatment abroad for impoverished patients, the Members of European Parliament have planned an alternative to the above-mentioned principles: the optional “prior information”. According to it, the patient informs the health insurance fund in advance about the planned treatment and he is given in exchange a written confirmation of the health insurance fund, on which appears the highest amount which will be reimbursed. Then, this confirmation will be brought to the attending physician and the patient’s health insurance fund will directly pay the reimbursement.

Prior authorization for hospital treatments

For hospital treatments and highly specialized treatments, the member states can introduce a prior authorization system. However, the directive does not define clearly the term “hospitalization”: It is up to each member state to give a list of all types of treatments which require a prior authorization to the appropriate authority and to the EU Commission. Therefore, the same treatment might require prior authorization in France and not in Germany! On this particular point, the future directive does not contribute to standardize the regulations in Europe. However, it is at least possible for the patient to have a look at the list in question in advance, to comply with the applicable legislation. 

Setting up of a network of national points of contact for information

These independent points of contact for information (one point of contact for each member state) aim at strengthening the patients’ trust in the European Healthcare Market, where concrete help is provided on the spot. In this way, patients have access to information of quality, understandable and exact, to choose (or not) a treatment abroad.  For instance, the points of contact inform the patients about the reimbursement conditions, the various treatment methods in the different EU Member States, the particular regulation concerning practitioner’s responsibility… etc. Thus, the patient can obtain extensive information about a practitioner or a hospital in another European country, and refer to it to make up his mind for (or against) a treatment.

Ensure quality of treatments in Europe

Besides, the directive aims at guaranteeing quality and security of treatments within the European Union. Each EU member state has to define clear quality norms, according to which cross-border health services will be carried out, and to ensure that the European health instructions will be observed. 

A particular attention for patients suffering from an orphan disease

The members of the European Parliament have planned a particular regulation for patients suffering from an orphan disease. Therefore, patients suffering, or being suspected to suffer from a rare disease have a right to be treated in another EU country and to be reimbursed, even if the diagnosis or the treatment in question is not planned in the legislation of their country. However, such a treatment has to be subjected to prior authorization. 

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