Title: Cross-Border Healthcare: Austria Reported One Claim in 2024
Author: Arthur Harmash
Published: 2026-09-23 (updated 2026-09-30)
Source: https://lymyvoyage.com/articles/cross-border-healthcare-austria-one-claim
Citations:
- https://health.ec.europa.eu/document/download/b92c70f2-7415-465d-82c9-508f595fe880_en?filename=crossborder_2024_patient-healthcare_data_en.pdf
- https://health.ec.europa.eu/cross-border-healthcare/overview_en
- https://op.europa.eu/webpub/eca/special-reports/cross-border-health-care-7-2019/en/
- https://europa.eu/youreurope/citizens/health/planned-healthcare/right-to-treatment/index_en.htm
- https://health.ec.europa.eu/document/download/22520255-bb91-4896-8266-b150d749b900_en?filename=cbhc_2021-2023_trend-report_en.pdf
- https://health.ec.europa.eu/publications/factsheet-cross-border-healthcare-2024_en
---
Every EU citizen has the right to be treated in another member state and have their own country pay towards it. The right is real, it is written into Directive 2011/24/EU, and it has existed since 2013.
In 2024, Austria's health system received one claim under it. Portugal received one. Malta received four. Spain received eleven.[^1]
Austria received one cross-border treatment claim in 2024. One. For a country of nine million people.
Europe sells this as a headline right: get treated anywhere in the EU, get reimbursed at home. So why does almost nobody use it?
Across 25 reporting countries in 2024 there were 292,223 reimbursement claims. Germany alone accounts for 177,653 of them. Take the three largest countries out and thirteen are left reporting fewer than 1,000 claims each. Italy managed 333. Greece 82. Latvia 30.
What the right does not tell you: you pay the whole bill first. You get back only what your own system would have paid at home, or the treatment country's price if that is lower.
The counterargument: where the route is actually used it works well. EUR 118 million was reimbursed in 2024, and 99.1% of claims were granted.
What this cannot prove: low claim counts are not proof of low demand. Several countries admit they cannot separate this route from the older one, so some real use is being counted elsewhere.
The right works. Almost nobody reaches it. Europe's own auditors said in 2019 that fewer than one in five citizens knew it existed, and the 2024 numbers have not moved.
## What the Commission's own numbers say
The European Commission collects this data every year from the national contact points each member state must run.[^2] The report for reference year 2024 was finalised in April 2026 and published, with a summary factsheet, on 12 May 2026.[^1][^6] Twenty-nine of the thirty countries asked returned a completed questionnaire.[^1]
Two separate routes run under the Directive, and they behave differently.
| | Needs permission first | Requests in 2024 | Share approved | Reimbursed |
|---|---|---|---|---|
| Care needing prior authorisation | Yes, in the 20 countries that operate one | 6,350 | 74.7% | EUR 8.86 million, from 10 reporting countries |
| Everything else | No | 292,223 | 99.1% granted | EUR 118.15 million, from 25 reporting countries |
Source for both rows: the Commission's reference-year 2024 dataset.[^1]
The second row is the one ordinary patients use. It covers outpatient care, scans, dental work and anything that does not involve a hospital bed.
## The distribution is the story
The headline total of 292,223 looks like a working system. It is not evenly spread.
Germany alone reported 177,653 of those requests, Sweden 30,998 and Denmark 26,727.[^1] Everyone else is far behind. Poland reported 14,197, Slovakia 13,680 and Norway 12,180.
Then the numbers collapse. Thirteen countries reported fewer than 1,000 requests each in 2024.[^1] Italy managed 333. Greece reported 82, Latvia 30, Malta 4.
Prior authorisation is more concentrated still. Of 6,350 requests, Germany received 4,194, Luxembourg 1,069 and Slovakia 542. Those three account for 91.4% of the total.[^1] Ireland, Portugal and Romania each reported receiving none at all in 2024.[^1]
## Why the German number should not reassure anyone
Germany's figure is the largest and the least usable. The Commission states plainly that Germany could not distinguish requests made under this Directive from those made under the older social security coordination rules. Its reported total is a consequence of that.[^1]
So the single biggest contributor to the European total is a number that mixes two legal routes. Remove the uncertainty around it and the continent-wide picture gets smaller, not larger.
That pattern shows up over longer periods too. Across 2021 to 2023, France received 790,718 reimbursement requests, 57% of everything reported by all countries combined.[^5] Germany followed with 324,790 and Denmark with 73,826.[^5] On the treating side, Spain covered 234,635 cross-border patients over those three years, Portugal 108,809 and Belgium 100,238.[^5]
The European Court of Auditors reached the same conclusion in 2019. It found about 200,000 patients a year claiming under the Directive, fewer than 0.05% of EU citizens.[^3] The comparison it drew was with the older social security coordination route, which handled roughly 2 million claims a year.[^3]
The auditors also asked why. Citing a 2015 Eurobarometer survey, they found that fewer than 20% of citizens knew the right existed.[^3] Fewer than half of national contact point websites explained that two different routes exist at all.[^3]
## What the headline right leaves out
**You pay first.** Under this route the patient settles the bill and claims afterwards. Reimbursement is set at the home country's rate, or at the treatment country's price if that is lower.[^4] Whichever is cheaper is what you get back. A cheap procedure abroad can therefore refund less than you expected, not more.
**Permission is required more often than people think.** Care involving an overnight hospital stay, highly specialised treatment, or expensive equipment can all require prior authorisation.[^4] In 2024, 90.3% of approved authorisations were for care with an overnight stay.[^1]
**Refusal has a standard reason.** Where authorisation was refused in 2024, 86.4% of refusals were on the ground that the same care could be provided at home within a medically justifiable time limit.[^1] A long domestic wait is not automatically a qualifying one.
**Nine countries do not run an authorisation system at all.** As of 2024 that list runs Czechia, Estonia, Cyprus, Latvia, Lithuania, the Netherlands, Finland, Sweden and Norway.[^1] The route is simpler in those countries. Sweden and Norway also report some of the highest claim counts per head.
**The total is small against the systems it sits inside.** For the countries with complete data across 2021 to 2023, cross-border spending under the Directive came to less than 0.02% of their total health expenditure.[^5]
## How to use this if you are considering it
Start with your own country's national contact point, which every member state is required to operate.[^2] It is the body that tells you whether your specific treatment needs permission first, and what your system will actually pay.
Ask for the reimbursement figure in your own currency before you book anything, not after. Ireland's scheme publishes fixed amounts for this reason, and a published figure is the only kind you can plan against.
If the care involves a hospital bed, assume you need prior authorisation and apply before travelling. In 2024 that category was 90.3% of everything approved, and travelling first removes the option entirely.[^1]
And treat the low national claim counts as information about the process, not about the medicine. A right that one Austrian claim reached in a year is a right with an administrative problem, and the Commission's own auditors said so six years ago.[^3]
[^1]: https://health.ec.europa.eu/document/download/b92c70f2-7415-465d-82c9-508f595fe880_en?filename=crossborder_2024_patient-healthcare_data_en.pdf — European Commission, Directorate-General for Health and Food Safety, "Member State data on cross-border patient healthcare following Directive 2011/24/EU, Reference year 2024", final version April 2026 (published May 12, 2026). Accessed Sep 23, 2026.
[^2]: https://health.ec.europa.eu/cross-border-healthcare/overview_en — European Commission, "Cross-border healthcare: Overview". Accessed Sep 23, 2026.
[^3]: https://op.europa.eu/webpub/eca/special-reports/cross-border-health-care-7-2019/en/ — European Court of Auditors, "Special Report 7/2019: EU actions for cross-border healthcare" (published 2019), citing a 2015 Eurobarometer survey for the awareness figure. Accessed Sep 23, 2026.
[^4]: https://europa.eu/youreurope/citizens/health/planned-healthcare/right-to-treatment/index_en.htm — European Union, "Your Europe: Organising planned medical treatment in another EU country" (last updated Sep 16, 2026). Accessed Sep 23, 2026.
[^5]: https://health.ec.europa.eu/document/download/22520255-bb91-4896-8266-b150d749b900_en?filename=cbhc_2021-2023_trend-report_en.pdf — European Commission, Directorate-General for Health and Food Safety, "Member State data on cross-border patient healthcare following Directive 2011/24/EU, Trend Report, Reference years 2021-2023" (published 2025). Accessed Sep 23, 2026.
[^6]: https://health.ec.europa.eu/publications/factsheet-cross-border-healthcare-2024_en — European Commission, Directorate-General for Health and Food Safety, "Factsheet: Cross-border Healthcare in 2024" (published May 12, 2026). Accessed Sep 23, 2026.