Cyprus Mail

Cross-border medical care a reality in EU28

By Elias Hazou

CYPRIOTS are now a step closer to enjoying cross-border medical care throughout the European Union, following the adoption into national law of a European directive on patients’ rights, despite the absence of a universal health insurance system.

Under the legislation, passed unanimously by parliament, all Cypriot nationals – irrespective of whether they have public health insurance or not – will have the right to obtain healthcare across the EU-28.

The law, which will apply as of January 1, 2014, enshrines citizens’ right to go to another EU country for treatment and get reimbursed for their medical expenses. The patient’s national health authority will reimburse the same amount as it would if he or she were receiving the health care in their own country.

In the event that treatment in the destination country costs more than it does in Cyprus, the patient will pay the difference.

Most EU member states had missed the October 25 deadline for transposing the directive.

For patients, this means mainly greater choice of healthcare, more information and easier recognition of prescriptions across borders.

But it doesn’t mean that anyone can go anywhere and get healthcare, there are strings attached.

Patients will have to seek prior authorisation from their home country for any intervention that requires an overnight stay or “cost-intensive care”.

Member states can also deny requests if they believe the destination country presents a “safety risk” or the treatment can be provided at home without “undue delay.”

Authorisation can be denied if the treatment can be provided at home within a reasonable time limit, but patients can argue their case.

The legislation relates only to pre-planned medical interventions; emergency medical treatment through the use of the European Health Insurance Card is a separate issue.

In Cyprus, the ministry of health will be publishing the accompanying regulations to the law by the end of the year. Health authorities will be issuing two lists, one for ailments not requiring pre-approval for treatment abroad, and another for ailments that do require pre-approval. Rare diseases will be included in the former category.

Patients must also secure prior permissions from health authorities at home before some treatments that involve specialised and expensive procedures.

AKEL MP and former MEP Adamos Adamou said concerns over an influx of patients, straining local resources, were largely unfounded. He cited a study commissioned by the European Commission that suggested only 1 per cent of EU citizens use cross-border healthcare.

According to Adamou, choice is the key difference between the new legislation and the system that was in place today.

Up until now, Cyprus had inter-state agreements in place with a select few countries – like Greece and Israel – and patients applying for treatment abroad could only get it in those designated countries.

Another advantage of the new system will be tackling long waiting lists for operations, says Adamou:

“For instance, if a patient needs hip replacement but has to wait up to two years to get it here, he or she will apply for treatment abroad and should be approved.”

As per the EU directive, the health ministry here will also set up a national contact point, as well as a website, allowing people to obtain information on their rights and how the legislation works when it comes to paying in advance.

Asked whether in practice all Cypriot citizens would be eligible for cross-border healthcare, even though not all have national health insurance, Adamou said this remained to be seen.
“For example, will someone who doesn’t contribute to public health insurance be entitled to healthcare abroad and to reimbursement? This is a major point which the health ministry will have to clear up in its regulations.”

The text of the EU directive does refer to all citizens, but all EU countries – bar Cyprus – have a universal health system in place to which everyone contributes.

Cyprus currently lacks such a system, but under pressure from international lenders must establish one, the National Health Scheme (NHS), by the end of 2015.

In the coming weeks the health ministry will be running TV spots explaining what patients are entitled to.

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