Arlinda Gjypi (Versioni shqip)
EU citizens have the right to benefit from cross border healthcare and this possibility is offered to all of the citizens that work in these countries, whether immigrants.
Albanian immigrants who live and work in EU countries will now have the possibility to receive health care in all countries of the European Union, regardless of where they live. Such thing is defined in the Directive on the Rights of Patients and is confirmed by Mr. Bernd Christl, director of the National Contact Point for Cross border Healthcare in Germany.
In an exclusive interview for “Shëndet+” newspaper, Mr. Christl explains the procedures to be followed by emigrants living in Germany, as well as those in other countries of the EU to get healthcare they need in other countries.
Mr. Christl, recently a lot of Albanians are coming to Germany to live and work here. For the Cross-Border healthcare, do the Albanians that live and work in Germany have the right to be treated in other countries of EU?
Yes. All the Albanian citizens that live in Germany, work and are statutory health or fully private insured, have the right to profit from the Directive for Patients Rights, which includes the possibility for every European citizen to receive healthcare in every state of EU/EEA or Switzerland. In the Framework of the German law of the Social Insurance this is a benefit for all the persons who are statutory health or fully private insured.
What documents do they need to be treated in other EU countries?
When they use the Directive, they only need in Cases of prior authorization, a written confirmation from the statutory health insurance company (Insurance Fund) before they go. When they come back, they will get a reimbursement with a maximum amount of the German rates for the same treatment. The patient can choose a healthcare provider in another EU/EEA State or Switzerland for the treatment. The patient has to pay for the treatment in advance and get a reimbursement maximum up to the German rates, less from his Co-Payment rates and a administrative expense deduction in Germany.
If the patient will get a treatment which is part of the statutory health insurance basket of another EU/EEA State or Switzerland, he can ask the statutory health insurance company in Germany for a prior authorization with the form E112/S2.
With that form he can go to the statutory health insurance company in the State of treatment and they will give him a national form for the healthcare provider, where he get the same treatment as a patient who is insured in that country. He only has to pay his co-payment like a statutory health insured person in the state of treatment. The other cost will be directly settled with health insurance funds via the Liaison Agencies. That procedure only works for statutory health insured patients.
Are there any barriers for them?
The health insurance funds are only forced to authorize a cross border health treatment when there is no chance to get a treatment or to get a treatment in time in Germany. In other cases they can authorize a cross border treatment, but they are not forced to do it. Most of the treatments are available in Germany.
Do the Albanians that live and work in the countries of EU have the right to be treated in Germany?
Normally yes, but in practice it depends on the procedure that the member state has implemented and apply the cross border healthcare Directive or the Regulations 883/2004 and 987/2009.
What documents are required to obtain health care in Germany?
The same documents that people insured in Germany need to benefit health care in other countries of EU, as I mentioned above.
Are there any obstacles?
As I said above, the Funds are forced to give authorizations only for health treatments that are not provided in the origin country, but are not obligated to give the authorization in case that the treatment is found on that state.
However, before any action, the patient must ask his statutory health insurance company to get all the relevant information needed for his problem and to know about the amount of the refund concerned. To be safer, you can get information on Cross Border Contact Points, established for this purpose.
(HERE you can find the National Contact Points for cross-border healthcare in EU countries)
