European directive 2011/24/EU

The European directive 2011/24/EU* states that, subject to certain conditions, you are entitled to travel to another country in the European Union* for planned healthcare. If you have health insurance coverage in Belgium, the same is true when you travel to Iceland, Liechtenstein, Norway or Switzerland for planned healthcare.


What should you do?

Unlike Regulations (EC) 883/2004 en 987/2009*, the European directive 2011/24/EU* does not require prior authorisation* for all planned healthcare in another country. Depending on the type of treatment, either:
- you need no prior authorisation* (e.g. consultation with a specialist, etc.),
- you do need prior authorisation* (e.g. a surgical procedure in a hospital requiring at least one overnight stay, certain outpatient treatments involving the use of highly specialised and expensive infrastructure or equipment).

Before you leave for abroad, you are advised to contact your health insurance fund*, which can give you more information as to what you need to do before and after receiving the planned treatment. Your health insurance fund* can also inform you as to what is and is not permitted, and let you know of any particular reimbursement conditions (including which types of healthcare do or do not require prior authorisation*, the level of any reimbursement for the planned treatment to be received abroad, specific implementing rules concerning reimbursement, etc.).


Reimbursement

If you travel to another country in the European Union*, Iceland, Liechtenstein, Norway or Switzerland for planned healthcare treatment, you must pay the cost yourself. It does not matter whether the healthcare provider is working within the public health system or is a private care provider.

On your return you must submit the invoices to your health insurance fund* and claim reimbursement. Reimbursement will be according to the rules and rates of the Belgian compulsory heath insurance regime. This means that:
- healthcare is only reimbursed if it is also reimbursed in Belgium;
- the reimbursement can not be higher than the sum reimbursed for this type of care in Belgium.

The amount reimbursed can not be higher than the amount which you paid for the healthcare in question.

Attention !

If you live in Cyprus*, Finland, Ireland, the Netherlands, Portugal, Spain, the United Kingdom, Sweden, or Norway,
and
- you currently receive a Belgian pension or Belgian disability benefit, and if you, and your family members, are therefore entitled to healthcare in that country paid for by Belgium,
or
- if you, as a family member, are entitled to receive healthcare in that country paid for by Belgium, while the main beneficiary lives in another country of the European Union*, Iceland, Liechtenstein, Norway or Switzerland,
and
you have travelled to another country of the European Union* - with the exception of Belgium – for planned healthcare according to the European directive 2011/24/EU* (e.g. the healthcare is supplied by a private healthcare provider or in a private hospital),
then
you must pay the cost yourself upfront.

On your return home you must submit the invoices to the health insurance fund* in your country of residence and claim reimbursement. Reimbursement will be according to the rules and rates applied by the public health insurance regime in your country of residence.

Example
You receive a Belgian pension and live in Spain, where you are entitled to healthcare paid by Belgium. You travel to London (United Kingdom) for a consultation with a prominent specialist working in a private hospital. You pay the full amount on the invoice, and on your return home, you submit the original invoice to the Spanish health insurance fund*, which will reimburse the costs according to the rules and rates applied by the Spanish public health insurance regime.

Beforehand, therefore, contact the health insurance fund* or the National Contact Point of your country of residence. They can give you more information as to what you should do before and after the planned treatment abroad. They can also inform you as to what is and is not permitted, and of any particular conditions applying to reimbursement (including which types of healthcare do or do not require prior authorisation, the level of any reimbursement for the planned treatment abroad, specific rules governing reimbursement, etc).
 

 

More info?

Contact your health insurance fund*. You can also find more information in a European Commission brochure.

* cf. Glossary