Planned Healthcare in Europe for Lothian residents

Transcription

1 Planned Healthcare in Europe for Lothian residents Introduction This leaflet explains what funding you may be entitled to if you normally live in Lothian (Edinburgh, West Lothian, Midlothian and East Lothian council areas) and are travelling abroad to another European country for planned 1 healthcare. It also describes how to apply for funding. (If you don t follow the correct process you may have to pay for the costs of your healthcare yourself). Travelling abroad for planned healthcare The European Economic Area (or EEA) is a group of European Union countries plus Iceland, Liechtenstein and Norway. If you are thinking of going to another EEA country (or Switzerland) for planned healthcare, European law states that in reasonable cases this should be paid for by the country that a person normally lives in. This means that people normally living in Scotland can ask the NHS (National Health Service) in the UK to pay for healthcare in other EEA countries. People can only get funding for healthcare they would normally be offered within the NHS in Scotland. There are two ways to get NHS-funded healthcare in other EEA countries: The S2 Scheme (formerly known as E112) The EU Cross-Border Healthcare Directive (also known as Article 56) Countries included in the European Economic Area are listed below. Austria Greece Netherlands Belgium Hungary Norway* Bulgaria Iceland* Poland Cyprus Ireland Portugal Czech Republic Italy Romania Denmark Latvia Slovakia Estonia Liechtenstein* Slovenia Finland Lithuania Spain France Luxembourg Sweden Germany Malta * At the time of writing Iceland, Norway and Liechtenstein are not yet covered by the EU Cross-Border Healthcare Directive 1 UK citizens travelling in EEA countries can access free or reduced-cost emergency state-funded healthcare using a European Healthcare Insurance Card (EHIC). EHIC does not cover private healthcare; or any planned treatments or planned operations. You can apply for an EHIC card on the Department of Health NHS Choices website at: Updated June

2 If you live in Lothian, you should discuss your plans with NHS Lothian Safe Haven Office before you make any travel or medical arrangements for planned healthcare in another EEA country. Tel or NHS Lothian Safe Haven Office will talk to you about the choices available to you. The S2 Scheme (formerly known as E112) The S2 scheme covers only state-funded healthcare in another EEA country or Switzerland. Healthcare is provided under the same funding arrangements that apply to residents of the country you are visiting. This could mean that you have to pay for part of the healthcare costs yourself. If you want to use the S2 scheme you must contact the NHS Lothian Safe Haven Office before you travel for healthcare. They will discuss the options available to you and tell you what information you need to provide. If NHS Lothian agrees that you can travel to an EEA country for healthcare under the S2 Scheme, the Safe Haven Office will complete the appropriate paperwork for you and they will send this to the UK Overseas Healthcare Team in Newcastle for processing. If the Newcastle team agrees to issue an S2 form, they will send it directly to your home address in Lothian. You will then take the S2 form with you to the other European country where clinicians have agreed to provide your healthcare and give it to the hospital there. To be eligible for the S2 scheme you must: provide evidence that you normally live in Lothian (Edinburgh, West Lothian, Midlothian, East Lothian Council areas) provide a National Insurance (NI) number provide a letter from your NHS Lothian hospital doctor saying why the treatment is needed be applying to have healthcare in a state-funded hospital in the other EEA country check that the hospital will accept an S2 form arrange the dates when your healthcare is to take place The EU Cross-Border Healthcare Directive The EU Directive gives you the right to buy healthcare services in another EEA country 2 and to apply for reimbursement from the NHS, as long as the healthcare is medically necessary and would have been made available to 2 Currently excludes Iceland, Norway and Liechtenstein Updated June

3 you under the NHS in Lothian. You will need to provide a letter from the doctor in the other EEA country saying why you needed the healthcare, and NHS Lothian will then consider whether this healthcare would have been offered to you in Lothian in similar circumstances. The EU Cross-Border Healthcare Directive covers healthcare given in both state-funded hospitals and in private hospitals, however, there are restrictions on the type of care and the total amount of reimbursement available. In most cases, you will have to pay the initial bill for healthcare yourself. You can then apply for reimbursement when you return to Scotland, up to the amount the healthcare would have cost in NHS Lothian. If the healthcare in the other country is more expensive than in NHS Lothian, the balance will not be reimbursed. NHS Lothian Safe Haven Office will give you an application form to complete to apply for reimbursement. Original receipts must be supplied as proof of payment. If you are seeking reimbursement for healthcare that was not authorised in advance, you might be out of pocket for some time until all the paperwork is processed. To be eligible for the EU Cross-Border Healthcare Directive you must: provide evidence that you normally live in Lothian (Edinburgh, West Lothian, Midlothian, East Lothian council areas) provide evidence from the doctor in the other EEA country saying why you needed healthcare Please remember: evidence is required that the healthcare would have been offered to you in NHS Lothian in similar circumstances reimbursement will be limited to the cost of the same healthcare in NHS Lothian Prior authorisation by NHS Lothian is required for specialist services. In this situation you will need to apply to NHS Lothian Safe Haven Office for funding before going abroad for healthcare. Please contact NHS Lothian Safe Haven Office directly for more information about what types of healthcare are considered specialist. What should I do next? Not everyone is entitled to funding. For the S2 scheme, or for specialist services under the EU Cross-Border Healthcare Directive, prior authorisation is always required. The best way to know what you are entitled to receive is to Updated June

4 contact the NHS Lothian Safe Haven Office on or If you would like to apply to NHS Lothian for the S2 Scheme or the EU Cross- Border Healthcare Directive, the NHS Lothian Safe Haven Office will need the following details: Your name, address, date of birth, and sex Proof of Lothian residency National Insurance number (NI number) The healthcare which you require A letter from your NHS Lothian hospital doctor saying why the healthcare is needed The name and address of the hospital which will provide your healthcare in the other EEA country The name of the doctor who will be responsible for your safety while receiving the healthcare Dates when the planned healthcare is due to take place Arrangements for any NHS follow-up care when you return to Lothian Should you have already had healthcare, NHS Lothian will also need: Evidence that the healthcare was clinically necessary (usually this will be a letter from your doctor in the other EEA country. If you are seeing a doctor in NHS Lothian please let us know. We will check that the healthcare would have been provided by NHS Lothian if you had stayed here) Details of the cost of healthcare and proof of payment It is important for you to know that for either type of funding: You will need to pay for the costs of your travel insurance, accommodation and food; and in most circumstances costs of travel. It is strongly recommended that you have travel insurance which includes comprehensive medical insurance specifically covering travel for medical treatment. This is your responsibility. It is strongly recommended that you also have a European Health Insurance Card (EHIC) to cover emergency, state-funded healthcare. If problems or complications happen, you will have to pay for any additional costs, including additional travel costs e.g. air ambulance You are responsible for ensuring that the healthcare is appropriate and safe within the laws of the EEA country providing the healthcare (not under UK or Scottish legislation). NHS Lothian cannot vouch for the quality or safety of healthcare you may choose to use in Europe. NHS Lothian is not liable for the outcomes of any healthcare received in another EEA country. Treatment outwith the UK is not covered by the NHS clinical negligence scheme. Further information Updated June

5 For further information contact NHS Lothian Safe Haven Office by telephoning or or write to: Safe Haven Office Department of Public Health and Health Policy NHS Lothian Waverley Gate 2-4 Waterloo Place Edinburgh EH1 3EG You can get more information about the different types of funding for healthcare in EEA countries from the NHS choices website: hee112.aspx but please be aware that the application forms referred to on this website apply to people living in England only, not Scotland. Updated June