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Frequently Asked Questions
Frequently Asked Questions
What is the need for this new Directive?
What about the existed regulation in the area?
Where does the Directive differ from existing Regulations in the area?
What is the scale covered by the Directive?
From where can I get information about my rights to cross border healthcare?
What is the role of the National Contact Point?
Can I have access to my Medical Records?
What happens with my Medical Records in case these might be needed to be transferred to the MS I will be treated?
What are my rights in case something goes wrong when receiving treatment abroad?
Is there a procedure for filling out a complaint or seeking remedies and legal and administrative options to settle disputes?
What do I need to do before seeking treatment abroad?
Do I need a prior authorisation for receiving treatment abroad?
In which cases can prior authorisation be refused?
Do I need to pay for my treatment abroad on an up-front base?
For which cross border healthcare services can I be reimbursed?
Can I be reimbursed for travel and accommodation cost?
How can I ensure the continuity of the treatment back to my country?
Will my medical prescriptions be recognised in another MS?
Do I have the right for reimbursement for prescriptions executed abroad for the purpose of the exact treatment?
Do I have same treatment with the citizens of the MS that I will be receiving the treatment and for the same cost?
1. What is the need for this new Directive?
The Directive seeks to clarify the ground for patients to exercise their rights to reimbursement for healthcare received in another Member State, to provide assurance about safety and quality of cross-border healthcare and establish a formal cooperation between health systems.
2. What about the existed regulation in the area?
The Directive is not affecting the benefits provided to the EU citizens through the existing Regulations on social security. Whereas, it codifies the rights to healthcare treatment abroad which derives from the provisions of the EU Treaty on free movement and which exist alongside the rights created by the Regulations. Based on the existing Regulations patients will continue receiving care (including emergency care) when temporarily abroad and receiving planned care abroad given that they are granted prior authorisation from the competent institution in their home country.
3. Where does the Directive differ from existing Regulations in the area?
Under the Regulation (EC) No. 883/2004 prior authorisation is always required to access treatment in a different country than the country of affiliation, whereas under the Directive 2011/24/EU prior authorisation is needed for certain treatment categories listed in the “list” of the member state of affiliation, subject to certain criteria. In the case of Regulation (EC) No. 883/2004 if prior authorisation is obtained the actual cost is reimbursed, whereas in the case of the Directive if the treatment is on the “list” of prior authorisation reimbursement is provided on the basis of the cost of the specific treatment in the member state of affiliation. Under the Regulation (EC) No. 883/2004 a patient might be reimbursed for reasonable travel cost, whereas in the Directive is up to the Member State to decide, in very special situations, whether it will pay for travel and accommodation.
4. What is the scale covered by the Directive?
Probably only a small fraction of citizens (average of about 1% in the EU) will seek cross border healthcare, since patients prefer to receive healthcare in their own country.
5. From where can I get information about my rights to cross border healthcare?
Information on cross border healthcare can be provided through the National Contact Point set up in each member state.
6. What is the role of the National Contact Point?
National Contact Points will exchange information between them and provide practical information to patients on healthcare providers and restrictions on their right to practice, appeal and complaint procedures, mechanisms for seeking remedies and legal and administrative options to settle disputes, contact details of National Focal Points in other MS, accessibility of hospitals for persons with disabilities etc. Thus, patients will be in a position of making informed decisions.
7. Can I have access to my Medical Records?
Yes. Patients have the right for access to their Medical records.
8. What happens with my Medical Records in case these might be needed to be transferred to the MS I will be treated?
Patients who seek to receive or do receive cross-border healthcare have remote access to or have at least a copy of their medical records, subject to the Processing of Personal Data (Protection of Individuals) Law of 2001 and the Regulation of Electronic Communications and Postal Services Law of 2004.
9. What are my rights in case something goes wrong when receiving treatment abroad?
In such a case the health authorities in your own country has no jurisdiction, and you can not complain to them. Advice and assistance on this will be provided by your National Contact Point and compensation is totally eligible to the member state of your treatment.
10. Is there a procedure for filling out a complaint or seeking remedies and legal and administrative options to settle disputes?
In case that a patient wishes to fill out a complaint, he/she can do so by submitting a duly completed application form (available on website) to the National Contact Point (NCP) for further investigation. The NCP answers the complaint after a complete investigation and in accordance to the rules and procedures of the Ministry of Health. It is specified that the NCP cannot investigate complaints dealing with medical expertise or medical negligence or claim for compensation and with those dealing with disciplinary measures on issues that are under the competence of the Compensation Council of each legally regulated association or competent authority. The patient can then act against the decision by filing a hierarchical recourse to the Minister of Health in a period of time or filing a hierarchical recourse to the Court of Justice in a period of time not exceeding the 75 days from the date that the decision was notified to him/her by the NCP.
11. What do I need to do before seeking treatment abroad?
Before seeking treatment abroad you should consult the NCP for explaining you the provisions of the existed legislation in the area of receiving treatment abroad and explain you in which cases you might need a prior authorization and the consequent administrative procedures.
12. Do I need a prior authorisation for receiving treatment abroad?
A prior authorisation system is in place, which covers the health services listed in the Medical Institutions and Services (Adjustments and Fees) Laws of 1978-2000 and in a law orders issued by the Minister of Health. The patient submits its request for prior authorisation by completing and submitting to the NCP a “prior authorisation application form”. The application form is accompanied by a medical report which states the diagnosis/ disease, the history, the current state of health and the reasons for which, in the opinion of the physician, prescribe the receiving of cross-border healthcare for a provider in another Member State. The NCP forwards all application form to the Committees of Medical Experts which are nominated by the Competent Authority for the purpose of examining all requests for prior authorization. After the examination of the application form, the Committee sends its decision to the NCP accompanied by a detailed report. The NCP sends the final decision to the patient after the final approval by the competent authority.
13. In which cases can prior authorisation be refused?
Prior authorisation can be refused in the following cases: a) The patient, in accordance to clinical evaluation, will be exposed to patient-safety risk, b) the public will be exposed to a substantial safety hazard as a result of cross-border healthcare in question, c) the healthcare is to be provided by a healthcare provider that raises serious and specific concerns relating to the respect of standards and guidelines on quality of care and patient safety, d) the healthcare can be provided on its territory within a time limit which is medically justifiable, taking into account the current state of health and the probable course of the illness of each patient concerned.
14. Do I need to pay for my treatment abroad on an up-front base?
Yes. After receiving the treatment abroad and paying for it, you might be reimbursed by submitting a dully completed “application form for reimbursement of cost” to the NCP, accompanied by: a) a copy of Medical Identity Card or relevant certificate issued by the responsible sector of the Ministry of Health. b) a copy of prior authorization document, c) the original invoice or/and the original payment receipt or/and a certified copy of the medical prescription and payment receipt from the Pharmacy (depending on a relevant Legal Order on reimbursement or not of pharmaceuticals and medical devices), d) a copy of the medical report from the medical centre or the responsible healthcare provider in case of prior authorization, e) the completed and signed authorization form for Payments by FIMAS along with a written confirmation from the Bank stating the International Bank Identification Number (IBAN). The NCP will examine the application form in accordance to the provisions of the existed legislation and informs you accordingly, within a reasonable period from the day of application.
15. For which cross border healthcare services can I be reimbursed?
Reimbursement of healthcare services is provided based on: a) The list of services not subject to prior authorisation, included in a Law Order issued by the Minister of Health, b) list of services subject to prior authorization, as included to the Medical Institutions and Services (Adjustments and Fees) Laws of 1978-2000, c) services which not included in the previous paragraph (a and b) and subject to prior authorisation.
16. Can I be reimbursed for travel and accommodation cost?
Usually no. Travel and accommodation cost might be reimbursed only in exceptional cases and after a respective decision from the competent authority.
17. How can I ensure the continuity of the treatment back to my country?
Patients who seek to receive or do receive cross-border healthcare have remote access to or have at least a copy of their medical records, subject to the Processing of Personal Data (Protection of Individuals) Law of 2001 and the Regulation of Electronic Communications and Postal Services Law of 2004. In addition, the Legislation enables the recognition of prescriptions issued in another Member States, including specific information that shall be included in them.
18. Will my medical prescriptions be recognised in another MS?
Yes. Your medical prescriptions will be recognised in another MS if the recipe contains all the information specified in the "on Pharmacy and Poisons (Amendment) Act of 2013". You will be entitled to obtain the prescribed medicine provided that the medicine in question is authorised for sale and available in the country where you wish to have the product dispensed.
19. Do I have the right for reimbursement for prescriptions executed abroad for the purpose of the exact treatment?
The reimbursement or not of prescriptions executed abroad will be regulated by Law Order issued by the Minister of Health.
20. Do I have same treatment with the citizens of the MS that I will be receiving the treatment and for the same cost?
The Directive states that the principle of non-discrimination with regard to nationality shall be applied to patients from other Member States. Additionally, Member States shall ensure that the healthcare providers on their territory apply the same scale of fees for healthcare for patients from other Member States, as for domestic patients in a comparable medical situation, or that they charge a price calculated according to objective, non-discriminatory criteria if there is no comparable price for domestic patients.
Last Modified at: 21/11/2014 09:26:23 AM
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