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Treatment valuation by the NHS

Patients waiting for surgery in the NHS queues, have the right to go abroad and undergo surgery in a state or private facility, with a subsequent reimbursement of NHS treatment costs according the the laws outlined by the EU Directive on Cross-Boarded Healthcare. 


To qualify for treatment abroad, patients must meet certain criteria, such as a permanent address of residence in England and the right to treatment in the NHS. You can learn more about who qualifies for treatment abroad at the expense of the NHS on this page: https://med4eu.co.uk/en/why-med4eu/eu-directive

If you meet the above criteria, the unknown, which may prevent you from buying airline tickets and arranging the surgery, is the cost of treatment.


Under the Directive, patients themselves pay for treatment, and these costs are refunded by the NHS after returning home. Under the cross-border directive, the NHS is obliged to reimburse medical costs abroad only up to the valuation level of the medical procedure in England. This means that if the NHS values the treatment at, for example, £1000 and the patient has paid £ 1,200 for it, the NHS will reimburse £ 1000, and the patient will have to pay the difference from his/her own funds. If the cost of treatment abroad is lower than the NHS valuation, the NHS will provide a full refund.


Is it possible to obtain information on the upper limit of rreimbursement before treatment? Yes!


Before you receive treatment, you can apply to the NHS for a treatment valuation. The application is identical to the application used for post-operative settlement. They require, amongst others: NHS and NIN numbers, proof of address and a letter from the doctor confirming the need for treatment and the treatment plan. The more accurate a letter or medical report, the more accurately the NHS can price treatment.


After receiving a positive response from the NHS, the reimbursement of treatment is guaranteed, and secondly, patients know exactly what the refund limit is. This means that the patient can decide what standard of treatment he is interested in. In many cases, even the costs of high-end treatment in Poland do not exceed the limit of NHS refunds. In some cases, however, patients can decide whether, for example, they want to pay extra and choose a prosthesis from better materials, another hospital, etc. This is one of the undisputed advantages of treatment abroad under the Directive – flexibility in treatment choices.

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