The medical officer* has 45 calendar days to respond to your application. When doing so, he must take account of:
- your particular state of health,
- the degree of urgency and your individual circumstances.

He will inform you in writing of his decision. There are three possibilities:
- your application is approved:
• pursuant to Regulations (EC) 883/2004 and 987/2009*: the medical officer* grants you prior authorisation* (S2 form*);
• pursuant to the European directive 2011/24/EU* (= article 294, §1, 14°, of the Royal Decree of 3 July 1996): the medical officer* provides you with an ‘ad hoc’ document* confirming that you have been granted prior authorisation* to receive the planned healthcare;
- your application is turned down: in this case, the medical officer* must give reasons for this refusal;
- your application is incomplete or further information is required (e.g. request for a translation of a medical report so that the medical officer* can take a well-founded, informed decision, etc.). In this case, the medical officer* will inform you of the situation and ask for further information. If necessary, the medical officer* can summon you to a medical examination.

The 45 day period begins on the day following the day on which the health insurance fund* receives your written application.

If the medical officer* requests additional information, the term of 45 calendar days within which the medical officer* must react is suspended. The period begins to run again from the day after the day on which the additional information is received.

If the medical officer* does not respond within 45 calendar days, then your health insurance fund* must grant you prior authorisation*.


More info?

For more information, contact your health insurance fund*.

 

* cf. Glossary