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Routes of accessing planned medical treatment in Europe on NHS

Patients considering treatment abroad can choose between two routes: S2 route and EU Directive route. The three basic elements are different for each treatment: the way patients pay for treatment, the treatment sector (private / public) and the application process.

Treatment costs

S2 route

NHS pays for treatment. In some cases, the patients have to pay part of the cost of treatment from their own means, depending on the rules of the country.

EU Directive

The patient pays for the treatment and then applies for a refund to the NHS. Reimbursement is made up to the NHS Medical Benefit Pricing Limit – i.e. if the NHS charges a medical fee of £1000 and the patient pays £1500 for the same treatment, the NHS returns only £1000 to the patient. If the patient has paid only £800 then the NHS will reimburse the full cost of the treatment.

Private or state sector?

S2 Route

Treatment with the S2 route is performed only in state institutions (eg in NFZ hospitals in Poland).

EU Directive

Treatment in the path of an EU directive can take place in the private or state sector.

Application process

S2 Route

Prior to the treatment, you must apply to the NHS to give you a permission for treatment abroad. If the application is considered positive, then the patient receives a confirmed S2 form which must be presented at the hospital abroad.

EU Directive

Patients wishing to benefit from cross-border healthcare under the EU Directive may apply for reimbursement of treatment costs after the treatment has taken place. Only in highly specialized operations a pre-treatment application is required, where the NHS confirms the patient’s right to medical treatment and reports the value of the medical treatment (i.e. the maximum limit of reimbursement). With Med4EU, all patients who undergo surgery benefit from the option of prior NHS assessment, ensuring that the maximum amount of costs of the planned treatment is reimbursed.

Why does Med4EU mainly handle the Cross-Border Directives?

The mission of Med4EU is to provide patients with access to the highest quality medical care. We believe that treatment in highly specialized and vetted clinics in Poland gives the best results. Therefore, as part of our services, we give our patients the opportunity to undergo treatment in the best Polish clinics with later NHS cost reimbursement. The patient’s financial contribution is reduced to an absolute minimum. For patients who are unable to cover their own medical expenses prior to the reimbursement, we offer assistance in obtaining a loan for treatment, because we believe that everyone, regardless of financial status, deserves the highest quality treatment.


For more information about the two possible routes of obtaining planned treatment abroad on the NHS, please go here.

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