Obtaining Treatment Abroad

There are three routes through which treatment within the European Economic Area can either be fully or partially financially supported. It is important to understand prior to obtaining treatment how they differ, what you might be entitled to receive, how to apply for reimbursement and, importantly, what you’re responsibilities are in each circumstance.

It is important to recognise that no single route or any combination of routes covers all eventualities and you are therefore strongly advised to ensure that you have appropriate medical travel insurance before you travel.

The European Health Insurance Card allows access to emergency state healthcare. Article 56 of the European Cross Border Healthcare is primarily for planned care whilst the S2 route is solely applicable for planned care.

Emergency Care


The European Health Insurance Card (EHIC) allows access to emergency state healthcare. It is important to recognise that the EHIC does not cover the cost of treatment with non-state healthcare providers.

It is provided on request and free of charge. More information and how to apply is available via the following link (EHIC).

An EHIC allows access to emergency state healthcare at a reduced cost or sometimes for free depending on how healthcare is funded within the specific country. It covers treatment that is needed to allow you to continue your stay abroad until your planned return.

The EHIC is valid in all European Economic Area (EEA) countries and Switzerland.

Planned Care

There are currently two potential ways for you to receive Planned Care funded by the NHS  in another EEA country - the S2 scheme (S2) and the European Cross-border Healthcare Directive (European Cross-border Healthcare Directive)

The S2 (previously E112) Route

If an NHS Consultant recommends that you need treatment then the S2 (S2) route entitles you, in certain circumstances, to travel for state-funded treatment in another European Economic Area (EEA) country or Switzerland.

Treatment will be provided under the same conditions of care and payment as for residents of that country. This could mean you have to pay a percentage of the costs.

How to apply

You need to contact NHS Fife for prior authorisation of your planned treatment in another member state. In making this decision, NHS Fife will need to be satisfied that:

  • A UK NHS Consultant has recommended in writing that you be treated in the other EEA country and that a full clinical assessment has been carried out to demonstrate that the treatment will meet your specific needs.
  • The costs of sending you abroad for treatment are justified.  NHS Fife is responsible for spending public money efficiently and fairly.
  • The treatment is available under the other country’s state health scheme.
  • You are entitled to treatment under the NHS.

If the decision is that you can go abroad for treatment the appropriate paperwork will be passed to the Overseas Healthcare Team in Newcastle. They will then issue the S2 form to your home address. You will need to take this form with you when you go for treatment. For more information, contact the Overseas Healthcare Team on 0191 218 1999 or overseas.healthcare@dwp.gsi.gov.uk.

European Cross Border Healthcare – The Article 56 Route

Article 56 of the Treaty of the Functioning of the European Union (European Cross-border Healthcare Directive) sets out the circumstances in which patients may have a right to choose to travel to other countries in the European Economic Area (EEA) for treatment.  Article 56 does not apply between countries within the UK as the UK as a whole is the Member State.

The treatment which you wish to travel abroad to receive must be one that is funded by NHS Fife and must not be a Prescribed Service. A list of prescribed services can be found at  Prescribed Services.  

The level of reimbursement will be limited to the lower of the cost incurred or the cost of the equivalent treatment in NHS Fife.

The application form that should be submitted to NHS Fife can be obtained at the following link: European Healthcare Application.

Drug and Rehabilitation Services

Where patients are considering travelling abroad to obtain these services, they must be assessed by their GP and the treatment plan approved by NHS Fife before they travel for treatment. Otherwise reimbursement will not be considered.

Before You Travel

Before travelling abroad please apply for your free EHIC (EHIC) card and take out the necessary travel insurance.

Before considering travelling abroad for Planned Care please read the detailed advice in the links above. The Application Form and Guidance Notes can be obtained at the following link: European Healthcare Application.

Contact Us

Before travelling abroad to access health care please seek advice and advance consent from NHS Fife. If you pay for healthcare abroad without advance consent in writing from NHS Fife it may not be possible to reclaim these costs at a later date.

If you live within the NHS Fife area the first point of contact is

Craig Pratt
Assistant Director of Finance
3rd Floor, Hayfield House,
Victoria Hospital,
Hayfield Road
Fife, KY2 5AH
Telephone 01592 643355 ext 28697


European Economic area (EEA) Member Countries

Austria,  Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, UK



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