You find a specialist in Germany, Spain, or France who can treat you sooner. Can you simply travel there and make your home healthcare system pay?
The Legal Right, and Its Real Limits
Directive 2011/24/EU gives EU citizens the right to access healthcare in another EU member state and, under specific conditions, get reimbursed by their home country's healthcare system. The core principle: if you're entitled to a treatment at home, you can generally get it in another member state instead and be reimbursed up to what that treatment would have cost you at home — which may be less than what you actually paid abroad, depending on the price difference between countries.
Worth knowing before you assume this is a simple, well-used pathway: the European Commission's own 2022 evaluation of the directive found that cross-border care under it remains a very small fraction of total healthcare spending across member states — typically under 1%, in many cases far lower. A major reason is that most patients simply aren't aware the right exists, or don't know how to use it.
Prior Authorisation: The Step That Can Make or Break Your Reimbursement
Whether you need prior authorisation before travelling depends on the treatment and your home country's rules. As of the most recent Commission monitoring data, 19 of 28 reporting countries had a prior authorisation system in place. Where required, your home country's health insurance institution generally cannot refuse authorisation if you're entitled to the treatment under national law and it can't be provided at home within a medically reasonable timeframe — a principle established through EU case law (the Watts case) requiring that "reasonable time" be judged on your specific clinical circumstances, not just a generic waiting list position.
Getting this wrong is the single biggest financial risk in cross-border care: travelling for treatment that required prior authorisation, without having obtained it, can mean forfeiting reimbursement you'd otherwise have been entitled to.
Where to Actually Get Clear Answers: National Contact Points
Every EU/EEA member state is required to designate at least one National Contact Point (NCP) specifically to give patients information about cross-border healthcare — whether prior authorisation applies to your specific treatment, what documentation you'll need, and how reimbursement is calculated. This is the correct first stop before making any arrangements, not a private clinic's own marketing material about "EU patient rights."
What This Means Practically
- Contact your home country's National Contact Point before arranging anything — confirm whether your specific treatment needs prior authorisation.
- If prior authorisation is required, obtain it before travelling — going ahead without it risks losing reimbursement entirely.
- Understand that reimbursement is generally capped at what the treatment would have cost at home, not necessarily what you actually pay abroad.
- Keep every piece of documentation — the authorisation (if required), the treatment invoice, and medical records — reimbursement claims are paperwork-heavy.
Related Kibbo Tools
Sources
- EUR-Lex — Directive 2011/24/EU. eur-lex.europa.eu
- European Commission — Data on cross-border patient healthcare, reference year 2022. health.ec.europa.eu