More about treatment in another EU country

You are insured in the Netherlands and you want to undergo treatment in another EU country. You must comply with certain conditions in order to obtain reimbursement of your costs. It is therefore important that you ask your health insurer in advance which conditions apply to you for undergoing medical treatment in another EU country.

What should you do?

You should always contact your health insurer first. The health insurer has to inform you about what is the most favourable possibility for you to undergo treatment in another EU country: based on the Regulation or based on the Directive (see below). If you undergo treatment in another EU country based on the Regulation, then you will in any case need your health insurer’s prior permission. Therefore, you need to contact your health insurer well in advance. Your health insurer can inform you about how to submit an application and also has enough time to assess it.

Your health insurer pays the healthcare provider for the treatment

You will receive care in accordance with European Regulation 883/2004. This generally means that you do not have to pay for the treatment yourself; your health insurer will do this. You must have obtained permission in advance from your health insurer for this treatment. In this case you will receive an S2 or an E 112 form.

You can then obtain treatment that is statutorily regulated in the EU country in which you are undergoing treatment. As you are insured in the Netherlands, your health insurer will expect you to have a referral – just as in the Netherlands – for certain forms of care (e.g., care provided by a medical specialist or in a hospital). You may also be obliged to pay a personal contribution to the healthcare provider for the treatment.

The National Contact Point Cross-Border Health Care (NCP) of the country of your choice can inform you about which care is covered by the statutory health insurance in that country. A list of NCPs can be found on the page 'Other National Contact Points'.

In general your health insurer will also pay the costs if they have contracted the foreign healthcare provider.

You first pay for the treatment yourself

The European Patients’ Directive (Directive 2011/24/EU) also makes it possible for you to obtain reimbursement for your treatment in another EU country. In this case you will first have to pay the costs of the treatment yourself. Furthermore, you may also have to first obtain the prior permission of your health insurer. Your right to care is according to the conditions of your own insurance. If you comply with the conditions, then you claim the costs from your health insurer after your return. The health insurer will reimburse the costs up to the maximum sum that the treatment would have cost if you had undergone treatment in the Netherlands. Because it concerns non contracted care in particular, the health insurer is obliged to inform you in advance about the amount reimbursed.

Please note

If the treatment is more expensive than a similar treatment in the Netherlands, the extra costs will generally be at your own expense. Your health insurer can inform you about this.

Treatment of rare diseases

Centres of expertise for rare diseases

There are a number of centres of expertise in the Netherlands for the treatment of rare diseases. Using a search engine on the Orphanet website, you can find designated centres of expertise not only in the Netherlands, but also in other countries.

European Reference Networks

European Reference Networks (ERNs) are virtual networks involving healthcare providers across Europe. They aim to facilitate discussion on complex or rare diseases and conditions that require highly specialised treatment, and concentrated knowledge and resources. ERNs have already been launched on a range of thematic issues like bone disorders, haematological diseases and skin disorders. More ERNs will be established in the course of time. On the website of the European Commission you’ll find extensive information about ERNs and an up-to-date overview.

The European Commission has issued a flyer that explains what ERNs are and how they can help you. You’ll find this flyer on the right-hand side of this page under “Documents”.

Prescriptions from another EU country

If you were treated in another EU country, the foreign healthcare provider may have prescribed medicines or medical devices for you. A Dutch pharmacist or supplier of medical devices must accept the prescription if it contains the following information:

the patient's details;
details proving that the prescription is authentic;
details about the healthcare provider who wrote the prescription;
details about the medicine or medical device.

More infomation on this subject can be found on the website of the European Union.

Complaints or problems?

If you do not agree with your health insurer’s decision about treatment in another EU country (e.g., you were not granted permission) or about reimbursement of the costs, then you can ask your health insurer to reconsider it’s decision. If you do not agree with your health insurer’s reply, then you can put your dispute before the Dutch Foundation for Health Insurance Complaints and Disputes (SKGZ). If you think your health insurer has not reimbursed the right amount, you can report this at the NZa (only in Dutch). The NZa then checks whether the health insurer has complied with the rules and acts if necessary.

Have you undergone treatment in another EU country and do you have complaints about the healthcare provider or any other matters related to the treatment? The NCP of that country can inform you how to solve this with the healthcare provider or how you can submit a complaint.