Your right to have the costs of treatment covered:
- If you are entitled to a particular treatment in your home country, then you may have the right to be reimbursed when you receive it in another country.
- Your level of reimbursement will be up to the costs of that treatment in a state/NHS hospital in your home country.
- You may choose whichever healthcare provider you wish, whether public or private.
- For some treatments (certain in-patient or highly specialised services) you may be required to obtain authorisation from your own health system before receiving the treatment abroad.
- If you are facing a medically unjustifiable waiting time for treatment at home, then authorisation should be sought as you may be entitled to a higher level of coverage for your healthcare costs.
For more detailed information on these rights, please visit the EU Public Health site.
More comprehensive document on the cross-border health care legislation can be found here.
It is important to discuss your plans with your GP before making any final decisions about having state/NHS funded medical treatment in another European country.
EU Directive Eligibility Criteria
You’ll need to meet the following criteria to be eligible for funding under the EU Directive:
- You must be ordinarily resident in England.
- You can’t apply for funding outside the EEA.
- Evidence of your medical need must be provided.
- The treatment must also be available to you under the NHS.
- Some treatments require prior authorisation.
- Reimbursement will be limited to the cost of the same treatment under the NHS.
How it works
The EU Directive gives you the right to purchase healthcare services in another EEA country, including Bulgaria, and to apply for reimbursement from the NHS, as long as the treatment is medically necessary and would be made available to you under the NHS. In most cases, you will have to pay the costs upfront.
- You can claim reimbursement when you return, up to the amount the treatment would have cost under the NHS.
- Prior authorisation may be required in some cases. This will confirm whether you are entitled to the treatment and the level of reimbursement you can expect.
- You must be allowed to have treatment abroad if you cannot have the same treatment on the NHS within a medically acceptable period. If “undue delay” applies in your particular case, you must be granted authorisation.
Find out what types of services require prior authorisation here.
How to apply
If you seek prior authorisation for treatment or apply for reimbursement, you will need to complete the application form. You can read the supporting guidance notes regarding the application form here. When applying for reimbursement, original receipts and proof of payment must be presented.
Note: Please ensure that you are using the latest available form (as provided on this site) before submitting your application. Applicants using an outdated form may be asked to supply further information or resubmit their application. For your information, you can look for the latest available NHS information at Healthcare abroad.
There are two European legislations on cross-border healthcare. One is the Regulation (EC) No. 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social system under which the State of insurance can impose a prior authorisation for planned treatment in another Member State (Article 20). The second is the Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patient’s right in cross-border healthcare which does not require prior authorisation (Article 7), or at least only in very rare cases (see Article 8).
It is important to discuss your plans with your GP before making any final decisions about having NHS funded medical treatment in another European country.