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

¿Qué requisitos debo cumplir?

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

¿Qué documentos necesito?

• 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)

¿Qué plazo tengo para solicitarlo?

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

Plazo de resolución:

• 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.

Notificaciones:

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

Recursos:

• Alzada.

 Información general sobre recursos administrativos (760 kbytes)

Efecto del silencio administrativo:

Estimatorio

Legislación aplicable:

• 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).

Organismo:

Consejería / Centro Directivo:

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

Órgano gestor:

Gerencia de Salud de Área

Órgano que resuelve:

Gerencia de Salud de Área

Información adicional:

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 Portal de Salud de Castilla y León .