Thursday 19 September 2019

Treatment travel to EU now looks more enticing

Eilish O'Regan

Eilish O'Regan

Irish patients have shown a traditional reluctance to go abroad for treatment but a new EU law aims to make it easier to travel to another member state for care.

It could mean the Health Service Executive (HSE) will in future be asked more often to pick up the full cost or most of the bill if an Irish patient goes to any of the 26 countries in the EU.

The law brings clarity to the existing right of an EU citizen to get healthcare abroad, a perk which has been available for many years and used by several Irish patients.

However, they have found the entire process vague and complex, with a lot of exceptions and rules involved. And there were question marks over what the health service would cover by way of costs, leaving many people who applied having their requests rejected.

The new law still means that many who would like to avail of treatment in another EU country will be rejected. But it has clarified the existing rights and put them into a single piece of legislation.

It should also simplify the whole process and open it up to many who were unaware of their rights.

Each country, including Ireland, has two years to set up an office which will be a citizens information bureau to provide clear direction to Irish and other EU citizens on health services.

So, for instance, an Irish patient who is on a long waiting list for some operation and procedure can explore if the HSE will cover the cost of their care if they travel to Germany, where they can be seen without delay.

The new law says a patient can make a claim if they are on a long waiting list.

But how will that be measured by the Department of Health when it draws up its rules?

Is six months undue delay? Or do you have to be on a list for a year or more?

Will your doctor have to certify that the condition is deteriorating before the patient can avail of treatment abroad?

The EU office in Dublin said if "appropriate care can be provided at home in good time, authorisation can be refused but the member state will have to explain why".

Patients need to get prior permission from the HSE before going abroad if their treatment involves a hospital stay of more than one night, high-tech equipment, is risky, or raises quality or safety concerns.

So if the treatment is unproven or potentially dangerous permission can be refused.

However, for non-hospital care, patients can go abroad without prior authorisation and claim refunds when they get home.

Generally the patient will have to pay the costs themselves upfront and then be "reimbursed as quickly as possible".

To discourage health tourism, patients will only be refunded at rates applying in their home country.

If the treatment costs more in another country they must pay the difference themselves, and travel or hotel costs cannot be claimed back.

The new law should be most useful for people with rare diseases for whom specialised treatment is not available here. Five in every 1,000 people have a rare disease and their treatment abroad cannot be refused by the home country.

It is important to note that these rights currently exist so patients interested in care in the EU can explore their options and make their case to the HSE from today. They don't have to wait until mid-2013, the deadline for having regulations in place.

Also remember the European Health Insurance Card allows free emergency treatment in all EU countries.

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