Planned medical treatment under Regulation 883/2004
According to Article 20 of the Regulation 883/2004, the competent institution in one of the Member States of the European Union (EU), the European Economic Area countries (EEA - Iceland, Liechtenstein and Norway), Switzerland or the United Kingdom of Great Britain and Northern Ireland (UK), may issue the approval for planned medical treatment in another Member State.
The insured person shall submit to the competent institution for health insurance in her home country a request for issuing the approval before the planned medical treatment.
For more information on filing such a request, we would like to refer you to the competent institution for health insurance in your home country.
The approval shall be issued if the treatment in question is provided by the healthcare system in accordance with the provisions of the legislation applicable in the Member state in which the person resides, and providing that this treatment cannot be provided in her home country within the medically justifiable time-limit, taking into account her current state of health and the probable course of her illness (Article 20 paragraph 2 of the Regulation 883/04).
If the competent institution for health insurance issues the approval for receiving the planned medical treatment in Croatia, you will be issued an S2 form. This form can directly be submitted in the contracted healthcare facility where you are planning to undergo the treatment. Alternatively, it can be substituted for a medical certificate of illness in a regional or branch office of the Croatian Health Insurance Fund (CHIF), depending on the location of your temporary stay in Croatia. This medical certificate of illness then needs to be submitted to the healthcare institution.
Planned medical treatment, based on S2 form, can be performed solely in healthcare institutions in Croatia that have entered into an agreement with the CHIF on the provision of health care services.
During the treatment, you will be required to participate in the costs of health care (pay the participation), providing this is also mandatory for the same healthcare service for the persons insured in Croatia.
The rest of the approved expenses shall be borne by your competent institution for health insurance in your home country.
Planned medical treatment according to the Directive2011/24/EU
According to the Directive 2011/24/EU, the insured person in one of the Member States is entitled to receive a refund for the cost of the planned medical treatment executed in another Member State, i.e. outside the compulsory health insurance system.
Such planned treatment in Croatia may be arranged with the healthcare provider in which you plan to undergo the treatment, and you are required to pay the full cost of treatment.
For more information on the process of undergoing such planned medical treatment in Croatia, as well as the reimbursement procedure, please contact the competent institution for health insurance in your home country before going to Croatia.For more information on the process of undergoing such planned medical treatment in Croatia, as well as the reimbursement procedure, please contact the competent institution for health insurance in your home country before going to Croatia.
For the reimbursement of the treatment costs from the respective insurance provider, we recommend that you save your medical records and the original invoice in your name. The invoice needs to stipulate what healthcare services were provided and show that these were paid for in full.
Last update date: 07.02.2024.