Information on prior authorisation

A citizen seeking healthcare in another Member State of the EU will have to pay for the healthcare in advance and will be entitled to reimbursement by his/her regional authority, the National Institute for Healthcare Management or mutual society for civil servants, as appropriate, upon returning to Spain, provided that the healthcare provided is included in the National Health System's Common Portfolio of Services

In some cases, a citizen seeking healthcare in another Member State will have to request the competent authority of the regional authority where he/she resides, the National Institute for Healthcare Management or the mutual society of civil servants, as appropriate, for prior authorisation so the costs may be subsequently reimbursed.

Prior authorisation is necessary where:

  1. Hospital accomodation for at least one night is required.
  2. The healthcare requires the use of highly specialised or cost-intensive medical infrastructure or equipment.

Health benefits subject to prior authorisation

Prior authorisation has to be requested by completing the specific form available for downloading on the websites of the competent health authorities, regional authorities and mutual societies.

A reasoned resolution will be issued within one month either granting or rejecting authorisation and notice thereof will be given to the interested party. The appropriate appeals and complaints may be lodged against such resolution.

Reasons for refusal to grant prior authorisation

Health authorities may refuse to grant authorisation if the treatment or the service provider can pose a risk to the patient. Authorisation may also be refused if appropriate healthcare can be provided in Spain within a reasonable time limit that can be justified on medical grounds.

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