Healthcare was for long not considered a matter to be dealt with by the European Union. It was looked at as outside of the competence of the EU and the legal entitlements of the individual patient to access healthcare services, both inside and outside of its country of residence, was considered purely a matter of national law.
The right to seek healthcare cross borders and get the costs reimbursed by the home State was first based in the social security Regulation 1408/71. The famous rulings of Kohll and Decker from 1998, however, formed the starting point of some disputed interpretations by the European Court of Justice, which increased the right to reimbursement for cross-border healthcare further than the Regulation. The Court considered healthcare to be an economic activity and, therefore, to be “services” within the meaning of Article 57 of the Treaty. The Court has given several rulings on cross-border healthcare, which have lead to a great uncertainty about the individual entitlements to reimbursement for such healthcare.
This dissertation focuses on Directive 2011/24 on patients’ rights in cross-border healthcare, adopted by the European Union in March 2011, and especially the right to reimbursement for cross-border healthcare. In this dissertation the rules of the Directive are compared to the rulings of the Court of Justice, and it is discussed how the rules of the Directive affect patients’ rights to receive reimbursement for cross-border healthcare.
The main principle set out in the Directive is that patients are free to seek the healthcare they need in another EU Member State, and get the costs reimbursed by the home State. This rule may be limited by the Member States by overriding reasons of general interest, and furthermore, by introducing a system of prior authorization.
The Directive is found to give gives good clarification and practical effect to the rights that the Court has already recognized in its rulings. The Directive does not, however, broaden the right to seek treatment abroad. Due to the increased clarity, and the fact that many people were not aware of their rights to reimbursement for cross-border healthcare, more EU nationals are likely to use their right to seek healthcare cross borders in the coming years.