European Union, Overseas and Visitors Policy

This page contains advice for Patients relating to European Union and Overseas Health Policy

Advice for Patients 

European Health Insurance Card (EHIC)

If the UK leaves the EU without a deal on 31 January 2020, your access to healthcare when visiting an EU country is likely to change. If you are planning to visit on or after 31 January, you should continue to buy travel insurance so you can get the healthcare treatment you need, just as you would if visiting a non-EU country.

If you are using an EHIC issued by the UK, this will still be valid until 31 January 2020.

The EHIC entitles a person to free immediately, necessary treatment when visiting another EEA country or Switzerland. The card is completely free to apply for and allows a person to access free immediate treatment on the state health service of the other country. The card is not a replacement for travel insurance and will not cover all health care costs. Travellers are always advised to ensure they have an adequate level of travel insurance when travelling abroad.

You can find out more information on the card and apply for it from the Overseas Healthcare Team in Newcastle or by calling 0300 330 1350

Taking your Prescription to another European Economic Area (EEA) Country

If you are planning to have your prescription dispensed in another EEA country then there are certain criteria that need to be on your prescription form.  The criteria are set out in the Annex to EU Directive 2012/52/EU

Pre-Planned Treatment in in EEA 

The S2 Route 

The S2 route entitles you to state-funded treatment in another European Economic Area (EEA) country or Switzerland. Treatment will be provided under the same conditions of care and payment as for residents of that country.  This could mean you have to pay a percentage of the costs personally.

For example, in some countries, patients cover 25% of the costs of their state-provided treatment, known as a "co-payment charge". The state covers the other 75%.  If you received treatment under this health care system, you would be expected to pay the same co-payment charge as a patient from that country.

In some countries, as in the UK, care is completely free. This means the S2 will cover 100% of the costs of your care, so you would not be required to pay any treatment costs upfront.

With this system, the health service pays the same contribution as the country in which treatment is taking place. For example, for an operation that costs £8,000 of which you're expected to pay a standard patient co-payment charge of 25%, you will pay £2,000. The health service will pay the remaining £6,000 to the institution treating you. However, you may be able to claim back some or all of the co-payment when you return to the UK. 

How to Apply 

Applications are made through the Health and Social Care Board. The Board will decide whether to refer you to another member state for treatment. In making this decision, the Board will need to be satisfied that:

  • A health service consultant has recommended in writing that you be treated in the other EEA country, and that a full clinical assessment has been carried out to demonstrate that the treatment will meet your specific needs.
  • The costs of sending you abroad for treatment are justified.  The Board is responsible for spending money efficiently and fairly, in the interest of all the patients they look after.
  • The treatment is available under the other country’s state health scheme.
  • You're entitled to treatment under the health service.

If the Board recommends that you can go abroad for treatment, the appropriate paperwork will be passed to the Department of Work and Pensions which will issue the S2 form. You will need to take this form with you to the other member state where you go for treatment. For more information, call or email or to seek approval from the Board contact:

Health and Social Care Board
Services Contracts Commission Directorate
12 – 22 Linenhall Street,
Tel: 0300 555 0115
Web: /travelfortreatment/s2

Planning to give birth outside Northern Ireland 

If you want to give birth in another EEA country or Switzerland, you will need a valid European Health Insurance Card (EHIC) to cover you for routine medical care and an S2 form to cover the birth itself.

If you want to give birth in another EEA country or Switzerland, you will need a valid European Health Insurance Card (EHIC) to cover you for routine medical care and an S2 form to cover the birth itself.

To apply for an S2 covering maternity care, you need to write to the NHS Business Services Authority at the address below:

Overseas Healthcare Services
Bridge House
152 Pilgrim Street

Tel: 0191 2181999 (Option 3)


explaining why you want care outside the UK and enclosing the following information:

  • a maternity certificate (MATB1) or a letter from your GP or midwife showing your expected date of delivery
  • your health and care number or National Insurance number
  • your date of birth, your full Northern Ireland address and dates of travel
  • It is recommended that you have adequate travel insurance as the EHIC may not cover you for every situation.
  • Even if you plan to give birth in Northern Ireland and you're only going for a short trip abroad, you're advised to take a valid EHIC with you. The card will provide cover for all medical treatment linked to the birth if the baby is born unexpectedly.

Indicate whether you will be returning to Northern Ireland after you have given birth and whether you have already left Northern Ireland for the other country.

Fill in the Maternity S2 application form and send it, together with your MATB1 and all other required documents, to:

Overseas Healthcare Services
Bridge House
152 Pilgrim Street

The EU Cross Border Healthcare Directive

The EU Directive on cross-border healthcare gives you the right to access healthcare services in another EEA country. It covers treatment in both state-run hospitals and by private service providers, only treatment which is the same or equivalent to treatment that would be made available in the home state is subject to the Directive. There are only certain treatments which require prior authorisation by the HSCB. However the HSCB
encourage people to seek prior authorisation and discuss all treatments before travel abroad. Prior authorisation is required providing proof that the treatment is appropriate, medically necessary and is also available under the health service in Northern Ireland.

The patient pays the provider directly and submits original receipts as proof of payment to the HSCB for reimbursement – no other costs are reimbursed. Reimbursement cannot be refused on the basis of financial pressures or lack of funding within the HSC – the Directive provides patients with rights and entitlements.

As with the S2 route, if "undue delay" applies in your particular case, you must be granted authorisation. Find out more about entitlements and rules.

For more information and to ensure you don’t have any difficulties when claiming back your money, contact the Board before making any arrangements abroad.

For further information contact:
National Contact Point
Health and Social Care Board
12-22 Linenhall Street
Belfast BT2 8BS
Telephone: +44 (0)28 9536 3152

Related Legislation & Guidance

Related Legislation 

Advice to Health and Social Care Service

EU Cross Border Interreg Programme 

The European Union cross border Interreg IVA Programme ran from 2007 to 2013.  Within this Programme, the Department acted as lead partner for the '30m project ‘Putting Patients, Clients and Families First’.  This was a joint project with the RoI Department of Health, which was delivered on behalf of the two Departments by ‘Co-operation and Working Together’ (CAWT).  

Overall, the Putting Patients, Clients and Families First Project has been extremely successful, significantly exceeding its targets and bringing benefits to more than 52,000 patients and clients across the border area. The majority of activities have also been mainstreamed by the health and social care services in both jurisdictions.

The Interreg VA Programme began in 2014 and will continue until 2020.  Within the Programme there is an allocation for health and social care of €62m.  Over the duration of the Programme this will support activity in a range of service areas, as well as enabling greater use of eHealth initiatives and expanding current networks for healthcare intervention trials.
Details of both the Interreg IVA and VA Programmes can be found on the website of the Special EU Programmes Body.

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