Can the NHS Pay for Surgery Abroad? S2, the EU Directive and Brexit Explained

So an operation at a private hospital abroad is self-funded (or paid by private insurance, if your policy covers it).

The S2 route is a funding arrangement between the NHS and the state healthcare system of an EU country, Switzerland, Norway, Iceland or Liechtenstein.

• You must get prior authorisation from NHS England (or the relevant body in Scotland, Wales or Northern Ireland) before travelling.
• You need written evidence of a full clinical assessment stating why you need the treatment and within what time.
• If approved, you're treated under the same conditions as residents of that country — which can include a co-payment.
• Applications can take up to 20 working days to process, longer if information is missing.
• Travel and accommodation are not reimbursed.
• It does not cover private treatment.

The EU Directive route let patients pay for treatment in another EU country and claim eligible costs back from the NHS afterwards. Since the UK left the EU, reimbursement is only possible for treatment that started or was approved before 11pm on 31 December 2020.

This is why you may still see older articles or adverts promising a "refund" — for UK residents today, that route no longer applies.

A UK Global Health Insurance Card (GHIC) or European Health Insurance Card (EHIC) covers necessary state healthcare that becomes medically needed during a visit and can't wait until you're home. It does not cover going abroad for planned treatment, and it does not cover private hospitals.

You should still carry it when you travel — and have appropriate travel insurance. The NHS warns that most travel insurance policies don't cover planned treatment abroad, so you may need specialist cover.

If you choose a private hospital abroad, you pay the hospital directly. At our partner hospital in Jelenia Góra, Poland, prices start from €6,940 (about £5,970) for a hip replacement and €8,620 (about £7,420) for a knee replacement — against roughly £12,000–£20,000 privately in the UK.

• A 20% deposit secures your date and is paid directly to the hospital.
• The balance is due at least two working days before surgery, or on admission.
• Quotes are valid for 90 days and billed in euros.
• If you have private medical insurance, check whether your policy covers treatment abroad.

See our cost guides for knee and hip replacement.