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Health service not obliged to refund costs of hospital care abroad in full

Hospital costs incurred while travelling in the EU will only be refunded if the patient would have had the same treatment free of charge in his country of residence, European judges have ruled.

The case followed a complaint by a French national resident in Spain and insured with the Spanish social security system.

While on a trip to France, Mr Chollet underwent unscheduled hospital treatment and was charged a proportion of the costs, as per French healthcare legislation.

After the Spanish health service rejected his application for a refund he wrote to the European Commission, saying this breached European rules on cross-border care.

Rejecting the commission’s contention, the European Court of Justice ruled in case C-211/08 European Commission v Spain that the health authority in the member state of residence was not required to refund hospital costs if these costs are borne by the patient in the country where treatment was administered.

The institution of the member state of affiliation was required to reimburse the institution of the member state of stay, in which the care was administered, only as regards the costs incurred by that institution on the basis of the level of cover applicable in the Member State of stay, the Luxembourg judges said.

The patient, the court said, “has no right to insurance cover at the expense of the Spanish institution in respect of that part of the cost of the treatment which is not covered by the institution of the member state of stay.”

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