| Verified against primary record | |
| Position under EU law | Not an EU member state, but within the Commission’s collection[1] |
|---|---|
| Prior authorisation system | None[1] |
| Reimbursement requests (2023) | 9,522 received, 8,395 granted, 2,449 refused[1] |
| Average processing time | 44 days, against a 60-day limit[1] |
| National contact point | Norwegian Health Economics Administration[2] |
| Independently reported | |
| EU patients using the Directive each year | About 200,000, under 0.05 per cent of EU citizens[3] |
| Bands apply only to the rows beneath them. Granted and refused together exceed the number received, which the Commission attributes to requests carried over from the previous year, so the figures are not a within-year balance. All counts are claims by Norwegian insured persons for care obtained abroad and are not a count of foreign patients treated in Norway. No typical cost range is given because no official Norwegian source publishes prices paid by foreign patients. | |
Medical tourism in Norway occupies an unusual position in European data: Norway is not a member of the European Union, yet it reports into the Commission’s annual cross-border healthcare collection and appears in its tables alongside member states. That distinguishes it sharply from Switzerland and Serbia, which are also outside the Union but absent from the collection entirely. Norway reported 9,522 cross-border reimbursement claims for reference year 2023 and operates no prior authorisation system.
Outside the Union, inside the data
The Commission’s collection covers the EU member states together with Iceland, Liechtenstein and Norway, and, for the purposes of the social security coordination Regulations, Switzerland. Norway therefore submits a full return and is reported on the same basis as member states.[1]
This matters for anyone compiling European figures. A country’s absence from the collection does not indicate a small cross-border caseload, and its presence does not indicate EU membership. Norway is the clearest case of the second point: with 9,522 claims it reported a larger volume than most member states, including Finland, Slovenia, Ireland and Romania.[1]
By contrast, Switzerland files no return under the Directive at all, and Swiss treatment of German-insured patients is embedded inside the German figures, while Serbia appears nowhere in the collection because it falls outside its scope.[1]
The reported figures
Norway received 9,522 reimbursement requests, granted 8,395 and refused 2,449. Granted and refused together exceed the number received, which the Commission attributes to requests carried over from the previous year, a pattern it also records for Sweden and Poland. The within-year arithmetic therefore does not close, and a refusal rate should not be computed from these figures as though it did.[1]
Norway settled claims in an average of 44 days against a 60-day limit, placing it among the minority of reporting countries recorded as working inside their own deadline, alongside Estonia.[1]
Norway has no prior authorisation system, which places it with Estonia, Finland, Sweden, Cyprus, Lithuania and Latvia among the states that declined a power the Directive permits but does not require.[1]
Where Norwegian patients go
The Commission names the movements from Sweden and from Norway to Spain among the busiest reimbursement flows in the Union. This runs against the general pattern, which the same report describes as mostly involving neighbouring countries, and points instead to northern residents obtaining care in a southern country during extended stays.[1]
Spain was the largest recipient of incoming cross-border patients in the Union on the most recent comparable measure, at 46,138 in 2016, while reporting very few Directive claims of its own. The Norwegian and Swedish flows form part of that asymmetry.[3]
Norway’s designated national contact point is the Norwegian Health Economics Administration, the agency that handles health reimbursement claims.[2]
The framework
Under Directive 2011/24/EU the member state of affiliation must reimburse cross-border care where the treatment is among the benefits it covers domestically, capped at the level of costs it would have assumed and not exceeding the actual cost of the care received. Prior authorisation may be required only for care subject to planning requirements involving an overnight hospital stay or highly specialised and cost-intensive infrastructure, for treatments carrying a particular risk, and for providers raising serious quality or safety concerns.[5]
Eurostat separately maintains a collection of hospital discharges of non-residents, with tables for in-patients, day cases, bed days and average length of stay, reporting country of residence where member states can supply it. Individual cell values for Norway were not retrievable for this article.[4]
For scale, the European Court of Auditors estimated about 200,000 patients a year using the Directive across the Union, fewer than 0.05 per cent of EU citizens, with prior authorisation applying in around 1 per cent of cases.[3]
Limits of the evidence
These figures describe Norwegian patients obtaining care abroad, not foreign patients treated in Norway, for which no official Norwegian count was located. The within-year counts do not reconcile because decisions carried over from the previous year are included. No figure has been estimated for privately funded treatment of foreign patients in Norway, which appears in none of the sources consulted.
See also
- Medical tourism in Switzerland, also outside the Union but absent from the collection
- Medical tourism in Spain, the destination of the busiest Norwegian flow
- Medical tourism in Sweden, named in the same flow to Spain
- Healthcare for international retirees, a likely component of that flow
- Cross-border healthcare, the framework Norway reports under
References
- European Commission, Directorate-General for Health and Food Safety. Data on cross-border patient healthcare following Directive 2011/24/EU, reference year 2023. 15 May 2025. Verified against primary record: the report was opened and its scope covering the EU member states plus Iceland, Liechtenstein and Norway and, for the Regulations, Switzerland, the record that Norway has no prior authorisation system, the Norwegian row showing 9,522 requests received, 8,395 granted and 2,449 refused, the attribution of the excess to carry-over from the prior year as also recorded for Sweden and Poland, the 44-day average against the 60-day limit, the naming of the Sweden and Norway to Spain reimbursement flows, the statement that mobility mostly involves neighbouring countries, and the caveat that German figures include stays in Switzerland were read directly. Retrieved 23 October 2026.
- United Kingdom government publishing service. EEA countries and contact points. Verified against primary record: the list was opened and the designation of the Norwegian Health Economics Administration as Norway’s national contact point was read directly. The document does not state a publication date, which is recorded here as a limitation. Retrieved 23 October 2026.
- European Court of Auditors. Special Report 07/2019: EU actions for cross-border healthcare. 2019. Verified against primary record: the report was opened and the annual patient estimate, the share of EU citizens, the 2016 incoming patient figure for Spain and the share of cases requiring prior authorisation were read. Retrieved 23 October 2026.
- Eurostat. Hospital discharges and length of stay for inpatient and curative care (hlth_hosd), reference metadata. Last updated 15 December 2025. Verified against primary record: the metadata page was opened and the non-resident definition, the statement that country of residence is reported, and the list of non-resident tables were read. Retrieved 23 October 2026.
- European Parliament and Council. Directive 2011/24/EU, Chapter III, Articles 7 and 8. 9 March 2011. Verified against primary record: the chapter text was opened and the reimbursement rule in Article 7 and the three permitted but not obligatory grounds for prior authorisation in Article 8(2) were read. Retrieved 23 October 2026.
Sourcing note: this entry uses only official sources. No refusal rate has been computed, because the Commission records that decisions carried over from the previous year are counted, so the within-year denominator is unreliable. Norway’s presence in the collection despite being outside the European Union is reported as a matter of the collection’s scope, and is contrasted with Switzerland and Serbia for that reason. No official Norwegian count of foreign patients treated in Norway was located, and no figure has been estimated.