Can I claim a refund if I have to pay for treatment abroad?

Whether you can claim a refund for money you have paid for medical treatment abroad depends on several factors:

– Why you needed treatment: did you travel abroad specifically to receive medical treatment or did you need medical treatment in an emergency?
– Whether or not you had an EHIC (European Health Insurance Card) or travel insurance
– In which country you received the treatment

Travelling abroad for treatment

An EHIC card will not cover you for treatment that you have specifically travelled to receive; the EHIC is for emergency medical treatment that you might need while you are abroad.

The rules on how to claim refunds from the NHS for treatment received abroad are quite complex, and if you don’t follow the correct procedures you can end up out of pocket. If you are travelling to Europe to receive medical treatment, there are two ways you can cover the costs via the NHS: the ‘S2’ route and the ‘EU Directive on Cross-Border Healthcare.’ There are slightly different rules and procedures for both of these routes, but they essentially work in the same way. In a nutshell, you can travel abroad for treatment and seek a refund for your costs if your treatment is medically necessary and would ordinarily be funded by the NHS in the UK.

If you get prior approval from the NHS, you can travel abroad and receive treatment in the same way as a resident of that country would. This might mean that you have to pay a contribution upfront towards your treatment (if that’s what residents have to pay – rather like we in the UK pay a contribution to dental treatment and prescriptions), called a ‘co-payment.’ But you can apply to recover that money from the NHS when you return home.

Using an EHIC

If your treatment abroad is not planned (you need treatment unexpectedly while already abroad, including for a pre-existing medical condition, or for routine maternity care), you must produce your EHIC to the doctor or hospital where you seek treatment. This ‘European health card’ proves that you are entitled to be treated in the same way as a resident of that country would. So, if you were in a country where its residents would normally be expected to pay 25% of their medical treatment costs, you would also be expected to pay 25%, usually upfront.

This means that you will not be charged the full cost of your treatment and you will save a lot of money.

But what about the money you pay upfront? Can you claim that back? Unfortunately, rules in place since 1st July 2014 mean that you can no longer receive a refund for the money you pay upfront in a European country.

This makes producing your EHIC even more important. Most countries in the European Economic Area (EEA) accept your European medical card as proof that you are entitled to be treated as a resident. However, the EHIC will not be accepted in the Vatican, Monaco, San Marino, the Channel Islands or the Isle of Man.

Travel insurance and your EHIC

If you have got travel insurance, you should be able to claim for medical treatment you have received abroad. However, if you do not take your EHIC or produce it to claim your discounted treatment costs, you will be charged by the doctor or hospital the full amount for your treatment. Most travel insurance companies will not refund the full cost of treatment, when you could have paid less by producing your EHIC. Others will not make you pay your policy excess if you have remembered to produce your EHIC (and therefore received discounted treatment).

Remember your EHIC

It is therefore vital that you take your EHIC with you when you travel. If you do, you will receive cheaper (or even free) medical treatment in line with what the residents of that country would ordinarily pay. You cannot claim back your co-payments from the NHS when you return, but you could claim them back from your travel insurance company – and if you have not used your EHIC, your travel insurance company might only pay a fraction of your claim.

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