Before the adoption of the Directive, Regulation 1408/71 of 1971 (now Regulation 883/2004) on the coordination of social security systems already set up a mechanism for reimbursement of healthcare for cross-border patients.
Article 20 of the Regulation provides that patients who wish to seek care in another Member State should request a prior authorisation to the competent authorities of their Member State of affiliation. Once the authorisation is granted, patients can directly have access to healthcare as if they were insured in the Member State of treatment.
Regulation 883/2004 still applies, and the Directive constitutes a complementary mechanism of reimbursement of cross-border healthcare in the EU. Patients have the choice to rely either on the system of the Regulation or on the Directive.
The text of the Regulation is also available in all EU languages at: