| Regulations
883/04 and 987/09 | Free movement of persons |
· Prior authorization required for all care
· Except for care becoming medically necessary during temporary stay in member state of treatment
· Prior authorization cannot be refused if
Ø Care is part of benefit basket
Ø Care cannot be delivered within medically justifiable time - limits
|
· Member State of Treatment
· “as if person was insured in member state of treatment”
· Formalities and conditions of member state of treatment apply
· Member state of affiliation pays directly
|
| Directive 2011/24 | Free movement of persons, medicines and | Prior authorization not required, except for care
· Subject to planning
· Presenting a risk for patient/population
· Provider raising quality and safety concerns
|
· Member State of Affiliation
· “as if person was treated at member state of affiliation”
· Formalities and conditions of member state of affiliation apply
· Patient advances cost and member state of affiliation reimburses
Except: if conditions of Dir 883/04 are met, these rules apply |