Cross-Border Healthcare

Rights and funding

Entitlement depends on statutory health insurance coverage and applicable rules. Directive 2011/24/EU applies across the EU and European Economic Area; different arrangements apply to Switzerland and the United Kingdom.

• Under the Directive, patients may use public or private providers, usually paying first and claiming reimbursement. The refund is normally limited to what their home system would pay for equivalent care and cannot exceed the actual cost.
• The S2 route allows eligible patients to receive planned treatment abroad within the destination country’s public healthcare system. You must obtain prior authorisation (approval before treatment) from your public health insurer or responsible healthcare authority, which issues the S2 form confirming this approval. Covered costs are normally settled between the relevant health insurance institutions under the destination country’s rules. [European Commission, Directorate-General for Health and Food Safety (2022). Guiding principles for information provision on prior authorisation systems across Member States]

Treatment normally needs to be covered by your healthcare entitlement. Under the Directive, prior authorisation may be required for overnight hospital care, highly specialised and costly infrastructure or equipment, or specified safety concerns. Travel and accommodation are not automatically covered.

Under S2, authorisation must be granted when you are entitled to treatment, and it cannot be provided within a medically justifiable time. Under the Directive, covered care that cannot be provided at home within that time is also protected, subject to safety exceptions. Rare diseases may warrant expert evaluation, but do not automatically guarantee funding. 

Care during a temporary stay

The European Health Insurance Card (EHIC) covers medically necessary care, including care for existing conditions, during a temporary stay under the destination public system’s conditions and charges. Necessary transfusions during a holiday or study visit may qualify; arrange them with the receiving centre beforehand. The EHIC does not cover journeys specifically for treatment, private care outside the public system or repatriation. Moving abroad requires separate insurance arrangements.

Planning care for haemoglobin disorders

Your usual specialist and the receiving centre should agree the care plan, including:

• Suitable expertise, compatible blood, transfusion appointments and uninterrupted medicines and monitoring.
• A clinical summary, red cell phenotype or genotype where available, all known red cell antibodies and transfusion reactions, current medicines and specialist contacts.
• An emergency plan and follow-up. For transplantation or gene therapy, confirm eligibility, capacity and funding for the full pathway.

EU medicine approval does not automatically secure reimbursement abroad; clinical trials have separate eligibility and funding arrangements. Through ERN EuroBloodNet, the European Reference Network on Rare Hematological Diseases, your clinician may, with your consent, seek expert advice using the updated Clinical Patient Management System (CPMS 2.0). This secure online platform allows healthcare professionals across Europe to discuss patient cases and advise on diagnosis and treatment, potentially avoiding travel.

Before you travel

National Contact Points in your country of coverage and destination can provide useful information about eligibility, authorisation, reimbursement, authorised providers, quality standards and complaints. Obtain a written cost estimate, keep approvals and payment records, and arrange transfer of medical records and follow-up. SOLVIT, a free service that helps resolve cross-border problems when a public authority applies EU rules incorrectly, may help with misapplied EU rights; formal appeal deadlines still apply.

EU prescriptions are generally recognised across borders, but dispensing rules and medicine availability vary. Check supplies and whether a paper prescription is required. MyHealth@EU exchanges electronic prescriptions and patient summaries between participating countries. The European Health Data Space schedules EU-wide exchange of these categories from March 2029, followed by images, laboratory results and discharge reports from March 2031.

TIF resources

Read Patient Rights in Cross-Border Healthcare, the second factsheet in TIF’s EU Policies Made Simple series, developed by TIF with considerations for patients with thalassaemia and other haemoglobinopathies. For practical advice on preparing for travel abroad, also consult TIF’s Travel Guide for Patients and Families. The links below also provide the Commission’s 2026 patient guides and latest annual data report, published in May 2026.

Useful links:

EU Cross-Border Healthcare Directive — Patient rights and reimbursement rules.

Your Europe planned treatment abroad — Treatment, authorisation and payment arrangements.

National Contact Points — National information and assistance.

European Commission patient toolbox — Patient guides and 2026 factsheets.

European Health Insurance Card — Cover during temporary stays.

TIF EU Policies Made Simple — The second factsheet on cross-border healthcare.

TIF Travel Guidance — Practical guidance for haemoglobin disorders.

ERN EuroBloodNet — Expertise in rare haematological diseases.

Using prescriptions abroad — Prescription requirements and medicine availability.

MyHealth@EU — Electronic prescriptions and patient summaries.

European Health Data Space — Implementation rules and timetable.

Latest EU healthcare mobility report — 2024 data published in May 2026.