Since 2011, patients’ rights in cross-border healthcare are specified by the EU-directive 2011/24/EU. Since then, the same right has applied to all EU citizens, regardless of their Member State. Nowadays it is possible to use outpatient medical services in another member state without prior authorization of the health insurance fund. The cost-takeover will be settled depending on the rates and the regulation in force in the patients’ country. Nevertheless it can be advisable to inform the health insurance in advance about the planned treatment and ask for confirmation. For hospital and highly specialized treatments this procedure is mandatory.
The possibilities of reimbursement differ between:
- You may ask for written confirmation from your insurance, stating that they will cover the costs of treatment before departure. Your health insurance will present you with a so-called “S2 document” which you can present to the doctor in Germany. You will then be treated like a person with statutory health insurance in Germany. Please note that your insurance is entitled to refuse the issue of the S2 document in case the planned treatment is not covered according to your countries national legislation.
- Alternatively you may ask your health insurance to reimburse you for the costs upon your return. The insurance will reimburse the costs up to the maximum amount which it would have paid if the healthcare in question had been provided in its country of origin. In this case you will be treated in Germany like a person with private health insurance. Please take into consideration, that costs may be higher than the reimbursement.
- Both variants entail advantages and disadvantages, which one is better often depends on the individual case.
- For hospital treatment, it is absolutely necessary that you ask your insurance for a confirmation to cover the costs before your departure.
- It is necessary for you to specify the nature of the treatment you wish to undergo along with the medical reasons and present an individual treatment plan for the hospital in Germany in the language of the country where the insurance is situated.
- The Authorization can be refused only if the treatment is not covered according to your national legal provisions or if an identically adequate treatment can be provided in your home country, taking into consideration your health condition and its expected development.
National Points of contact
The EU-Directive also provides for the establishment of a network of national points of contact. The aim is to strengthen the patients trust in the European Healthcare Market and provide concrete help and information. In Germany, the national contact point is located at the “Deutsche Verbindungsstelle Krankenversicherung – Ausland” (DVKA). Homepage: www.eu-patienten.de
Private health insurance
If you have a private health insurance, check your contract carefully. There may be differences concerning the reimbursement of medical treatment abroad. It is advisable to contact your insurance for detailed information.