Reimbursement for health care received in another member state of the European Union

HOW DO I QUALIFY?

• Be recognised as an insured person or beneficiary and be a holder of the SACYL Health Card.

What documents do I need?

• Application for reimbursement on a standard form to be sent to the Area Health Manager of the province where the insured patient has his or her health card at the time of receiving cross-border healthcare.
• The application shall be accompanied by the following documentation:

DOCUMENTATION to be submitted (90 kbytes)

WHAT TIME DO I HAVE TO ASK?

The deadline for the submission of the application shall be THREE MONTHS from the date of payment of the assistance received.

DEADLINE FOR RESOLUTION::

• The maximum period for resolving the procedure and notifying the decision will be THREE MONTHS from the date on which the application was received by the Area Health Management responsible for processing the procedure. Once this period has elapsed without an express decision having been handed down, the application submitted may be deemed to have been accepted.

NOTIFICATIONS:

• By Postal Mail at the address of the interested party.

RESOURCES::

• Alzada.

EFFECT OF ADMINISTRATIVE SILENCE::

APPLICABLE LEGISLATION:

• Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients' rights in cross-border healthcare (OJEU 4-04-2011).
• Royal Decree 81/2014, of 7 February, establishing rules to ensure cross-border healthcare, and amending Royal Decree 1718/2010, of 17 December, on medical prescriptions and dispensing orders (B.O.E 8-02-2014).
• Order SAN/1008/2014, of 18 November, which regulates the procedures for reimbursement and prior authorisation of cross-border healthcare (BOCyL 1-12-2014).

Organisation:

Organisation responsible

• Consejería de Sanidad
• Gerencia Regional de Salud (SACyL)

MANAGING ORGAN:

Gerencia de Salud de Área

ORGAN THAT RESOLVES:

Gerencia de Salud de Área

ADDITIONAL INFORMATION:

In some cases, in order to be entitled to reimbursement, prior authorisation is required, specifically the health benefits listed in

•   Annex II of R.D 81/2014 of 7 February (93 kbytes)

Reimbursement will only be guaranteed if the care provided is included in the common portfolio of services of the National Health System.

The patient must advance the cost of the expenses derived from the healthcare received. They will be reimbursed up to the amount that the same care would have cost if it had been provided in the territory of Castilla y León, in accordance with the provisions of Decree 78/2008, of 13 November, which approves the public prices for healthcare acts and services provided by the Regional Health Management of Castilla y León to patients who are not Social Security beneficiaries or when there are third parties obliged to pay, with the new amounts set out in the Annex to Decree 83/2013, of 26 December, which approves the new amounts of the public prices of the Community of Castilla y León; without in any case exceeding the cost actually paid. Accommodation or travel expenses will not be reimbursed.

Payment will be made by bank transfer to the account indicated in the corresponding application form.

For more information, please access the .