Your rights

What the Cross Border Directive is

A European Union directive of 2011 gives you the right to have planned treatment in another European Union country and to be paid back by the public health service that covers you at home. Its name is Directive 2011/24/EU on patients' rights in cross-border healthcare. In this English version of our site we call it the Cross Border Directive. Patients have been able to use it since 25 October 2013.

1. 2011

   European Union law

   The directive on patients' rights in cross-border healthcare gives you the right.

3. Your country

   Your public health service

   Applies it under its own rules, which we check with you.

5. You

   Your treatment, paid back

   Planned treatment in another EU country, and the cost claimed back from your own health service.

The same right applies in Norway, Iceland and Liechtenstein, which belong to the European Economic Area.

Who can use it

You can use it if you are entitled to public healthcare in a European Union country, and the treatment is one your public system provides at home. The hospital abroad can be public or private.

Which country pays depends on which country covers your public healthcare. If your pension or income comes from another country, that country may be the one that covers you. We ask you about this in our first conversation, before anything else happens.

What treatment is covered

Any planned treatment that your public system provides at home can be covered. Hip and knee replacements are common examples. Organ transplants, long-term nursing care and public vaccination programmes are not covered. Ablement helps with planned operations only: we do not arrange emergency care, cosmetic treatment, dental care or physiotherapy.

You may need a referral letter

Your country may ask you for the same things it asks for at home, such as a referral from your family doctor or a visit to a specialist first. It may not ask for more than that unless the directive allows it.

Most countries ask for a referral from a doctor before they pay back treatment abroad. The letter should go to the specialty, for example the orthopaedic surgeon, not to a named hospital, and it should be dated before your consultation with the hospital.

You may need to see the specialist first

Some countries ask that you have an outpatient consultation with the hospital's specialist before the operation, in person or by video. We tell you what your country asks for and arrange it with the hospital.

What is paid back

You pay the hospital first. After the treatment your country's public health service pays you back the lower of two amounts: what the hospital charged you, or what the same treatment would have cost at home, under your country's own rules and prices. Before you decide anything, we show you both amounts side by side, so that you know what, if anything, you would pay yourself.

Most countries do not pay back travel, accommodation or the costs of someone travelling with you. The refund is paid to you, the patient, into your own account. Nothing is paid to Ablement.

How and when you are paid back

The claim is made after the treatment, with the hospital's itemised invoice, your receipt and proof that you paid the hospital yourself. We prepare the claim pack and check every document. You sign the claim yourself; the claim is yours and the money is paid to you.

How long your country takes differs. We send your claim within five working days of your return home, tell you what your country says about its own times, and follow it up until it is decided. We cannot promise an amount or a date.

Permission in advance: some countries ask for it, others do not

A country may ask you to get its permission before treatment that involves a night in hospital or costly specialised equipment. This is called prior authorisation. Some countries ask for it; others ask for nothing in advance, or offer an optional advance ruling that tells you beforehand what you will get back. In the European Commission's latest count, 19 of the 27 member states have a prior authorisation system for some treatments.

Whether your country asks for it, and for which treatments, is the first thing we check, because treatment without a required authorisation is not paid back. If your country requires it, we prepare the application with you and send it before you commit to a date, and the hospital confirms your date only once the authorisation is granted. If you were treated before then, or without it, your country could refuse to pay anything back, and you would carry the whole cost yourself. Your country must answer within a reasonable time that it has set and published in advance, and we tell you that time before you accept the proposal.

If the claim is refused

Every country has a way to appeal, with its own deadline. We explain the decision and draft the appeal for you, free of charge; you sign and send it. We cannot promise the result, and we cannot cover a shortfall.

Your country's National Contact Point

Every European Union country has a National Contact Point for cross-border healthcare. It gives official information on your country's rules, free of charge, and the European Commission keeps the list of them on its website. Ablement is not a National Contact Point. If anything we say differs from what yours says, the official information applies, and we want to hear about it.

Ablement is not part of any public health service

Ablement ApS is a private company registered in Denmark. We are not part of any public health service and we do not act for one. We are not a hospital and we give no medical advice. The hospital pays us; you pay nothing for our service.

You can schedule a free call with us or write to hello@ablement.eu.