Since 2011, patients’ rights in cross-border healthcare are specified by the EU-directive 2011/24/EU. This article provides you with basic information on planned treatment in France.
On 9 March 2011, the directive 2011/24/EU on the application of patients’ rights in cross-border healthcare was officially signed by the European Parliament and the Council. Member States had to bring their national legislation into conformity by 25 October 2013
The Directive requires
1. to clearly define the reimbursement conditions for healthcare services obtained in other EU Member States;
2. to guarantee the quality and security of cross-border care;
3. to contribute to the cooperation between national healthcare systems and ultimately, to save costs.
For hospital treatments and highly specialised treatments (e.g. use of MRI), the Member States can introduce a prior authorisation system. However, the directive does not define clearly the term “hospitalisation”: it is up to each Member States to give a list of all types of treatments which require prior authorisation to the appropriate authority and to the European Commission. For instance, the same treatment might require prior authorisation in France and not in Germany! On this particular point, the directive does not contribute to standardising regulations in Europe. However, it is possible for the patient to have a look at the list in advance to comply with the applicable legislation.
This legal text is very important, since it settles patients' rights in Europe.
The same right is in force for all EU citizens, no matter if the patient comes from France, Romania or Spain for example. Before, the applicable right in case of cross-border healthcare was complex and hard to understand: the jurisdiction of the European Court of Justice and the national regulations clashed, and even specialised jurists had difficulties finding their way. One had to put an end to it so that it became clear and standardised.
Since it is possible for all European citizens to benefit from outpatient medical services in another Member States (for instance dental treatment, visit to the optician or general practitioner), without prior authorisation of their health insurance fund. The cost takeovers will be settled depending on the rates and the regulation in force in the patient’s country.
To avoid a two-speed medicine and to enable a treatment abroad for patients in need, the Members of the European Parliament have planned an alternative to the above-mentioned principles: the optional “prior information”. According to it, the patient informs the health insurance fund in advance about the planned treatment and he/she receives a written confirmation in exchange of the health insurance fund, on which appears the highest amount which will be reimbursed. Then, this confirmation is brought to the attending physician and the patient’s health insurance fund pays the reimbursement.
National points of contact
The EU-Directive also provides for the establishment of a network of national points of contact. The aim is to strengthen the patients trust in the European Healthcare Market and provide concrete help and information. In France, the national contact point is the Cleiss.