Directive No. 24
In short, this is the way for Romanian patients to get treatment abroad, while being reimbursed by the state. In reality, this directive doesn’t do much to help sick people who have no financial resources.
It is addressed to specific cases, consults, second medical opinions, etc., but doesn’t offer any real support to the patients, as they are caught between bureaucratic stages and the lack of precise deadlines and have no warrantee that the treatment will be reimbursed.
Our volunteer Luminita Barbu did an analysis of this directive:
1. The directive (as opposed to a regulation) isn’t applied directly and objectively, as member states have the right to decide what services represent the object of the directive and to limit the reimbursement of expenses.
2. It is not applied to primary medical services, long term services (“house calls”), or transplants.
3. The reimbursement refers not only to medical services, but also to medication and medical devices prescribed as a consequence of that particular medical service.
4. The reimbursement of the medical service is done at the patient’s level of insurance, in our case, Romania. In Romania, there is a theoretical (and highly unlikely) possibility that the state will reimburse the entire sum. This is not compulsory, so it will not happen.
5. According to this directive, Romania should have a transparent system of calculating the costs for medical services taking place abroad (I don’t think that is the case, a Government Resolution has decided that the price of an X-ray is 10 lei and that’s it, nobody knows the calculations that lead to this number). Also, they should publish the reimbursement fees for medical services.
6. On the basis of this directive, Romania can ask the patient to present a document signed by a Romanian physician (similar to a referral letter or to the medical report needed for the E112 form), along with the reimbursement documents.
7. In certain situations, a previous authorization is necessary (generally for tests that require a lot of financial resources, hospitalizations, intensive care, etc) – similar to the procedure for the E112.
8. When someone travels abroad, emergency services are still covered by the blue card.