Travelling to Europe for planned healthcare (S2 scheme)

If you’re eligible, under the S2 scheme you can get funding for planned treatment in:

  • an EU country
  • Switzerland
  • Norway
  • Iceland
  • Liechtenstein

The S2 scheme applies to public healthcare providers only. It can’t be used to pay for private treatment abroad.

If your application is approved, you will receive the same standard of care as residents of the country you will be treated in.

Health insurance

You should take your European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC). This is in case you need healthcare that’s not related to your treatment under the S2 scheme.

The EHIC or GHIC are not a replacement for travel insurance. This is because they may not cover all health costs. They also never cover the cost of returning you to your home country (known as medical repatriation).

You must have comprehensive travel insurance that fully meets your need. You should make your insurance provider aware that you’re travelling overseas for health treatment.

Who can get treatment under the S2 scheme?

You must meet certain criteria to be treated under the S2 scheme. Your local health board will consider if you’re eligible. To do this, they will assess your condition and circumstances.

Your treatment must be authorised by your local health board before you have it. Applications that are sent after treatment has been provided will not be considered.

You can’t use the S2 scheme for a clinical trial or an experimental part of any treatment package.

There is a different process for healthcare under the S2 scheme if you’re going to give birth abroad.

Criteria for treatment

The criteria for treatment under the S2 scheme is:

  • you must live in Scotland, be registered with a GP practice and be entitled to treatment from the NHS
  • your application must be approved by your local health board and the NHS Business Services Authority (NHS BSA)
  • the treatment is available under the treating country’s state healthcare scheme (not private)
  • your local health board must confirm that the NHS can’t provide the treatment you need, or equivalent treatment, in a medically acceptable timeframe (this is known as undue delay)
  • a clinician or healthcare provider in the EU, Switzerland, Norway, Iceland or Liechtenstein must provide written confirmation of the planned treatment dates and estimated cost
  • a full medical assessment from a clinician in the EU, Switzerland, Norway, Iceland or Liechtenstein supporting the diagnosis, need for treatment and timeline for treatment – this can be supported by a clinician in the UK

How to apply to use the S2 scheme

If you live in Scotland, you should apply for the S2 scheme using the application form. This form is the same as the one used for patients in NHS England.

You should discuss your plans with your local health board before deciding to travel abroad for medical treatment.

Your GP practice may also be able to tell you what options are available. Your GP can refer you to a clinician in your local health board if necessary. They will be able to discuss your options with you and confirm that:

  • the treatment you want is routinely available on the NHS to someone in your circumstances
  • you fully understand the conditions that you’ll be treated under
  • you fully understand any after-care or follow-up treatment you may need when you return to Scotland

How treatment under the S2 scheme is authorised

Your local health board must assess your application before it’s submitted to the NHS BSA. This is unless you’re travelling abroad to give birth.

You must also provide a completed declaration from your chosen healthcare provider. This confirms that your treatment will be provided through the country’s state healthcare system. It also confirms that they can accept an S2 certificate.

The declaration form can be downloaded from NHS England.

If your application is approved, the NHS BSA will issue an S2 certificate (payment guarantee form) directly to you. You must show the S2 certificate to the healthcare provider that’s treating you.

Paying for treatment under the S2 scheme

If your application is approved, the cost of your treatment will be the same as residents of the country you’ll be treated in. This may mean you have to pay some of the costs yourself. This is known as a co-payment charge.

In some countries, healthcare is free at the point of delivery. This means the cost of approved treatment under the S2 scheme will be covered and you won’t have to pay.

In other counties, patients cover part of their state healthcare costs. For example, a patient may have to cover 25% of their treatment costs. The state will then cover the other 75% of costs.

If you’re treated in a country with this system, you will have to pay some treatment costs. For example, an operation could cost £8000. You would be expected to pay a standard patient co-payment charge of 25% on this. This means you would pay £2000. The NHS would then pay the remaining £6000.

You should request an estimate of all treatment costs, including any expected co-payment. You should do this before submitting your completed application for funding to the NHS BSA.

Reclaiming co-payments

If you’ve paid a co-payment for your treatment, you may be able to claim back some or all of your contribution.

To get further information on co-payments, or apply for a reimbursement of a co-payment:

Travel and accommodation costs

Travel and accommodation costs linked to your treatment are not covered under the S2 scheme. They will not be reimbursed by the NHS BSA or your local health board. This includes travel and accommodation costs for people or carers travelling with you.

Maternity care and giving birth outside the UK

If you want to give birth in an EU country, Switzerland, Norway, Iceland or Liechtenstein, you need to:

  1. Download and complete the giving birth abroad application form.
  2. Provide a Maternity Certificate (MATB1) or a letter from a medical professional in Scotland. This should confirm your expected date of delivery.

You will need to send your completed application form and supporting documents to the NHS BSA.

Their email address isS2applications@nhsbsa.nhs.uk

You should email your supporting documents as a PDF attachment.

What care is covered?

Your giving birth abroad application only covers maternity care and delivery.

You should make sure you have a valid EHIC or GHIC for any other routine medical care you or your baby need.

An EHIC or GHIC are not a replacement for travel insurance. It may not cover all health costs and never covers repatriation costs.

You must have comprehensive travel insurance that fully meets your individual healthcare needs.

Further information is available through:

How to make an appeal or request a review

If you’re unhappy with the results of your application, you can request:

  • a review of the decision – if you have more information or evidence that wasn’t in the original application
  • make an appeal to your local health board – if you don’t agree with the decision to reject your application, but don’t have any more information or evidence

Further information

If you need more information about the S2 scheme, you should contact your local health board.

Last updated:
28 March 2024

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