| Verified against primary record | |
| Prior authorisation requests (2023) | 3 received, 0 authorised, 3 refused[1] |
|---|---|
| Amount reimbursed, authorised care (2023) | EUR 0[1] |
| Reimbursement requests (2023) | 200 received, 140 granted, 60 refused[1] |
| Average reimbursement processing time | 70 days, against a 60-day legal limit[1] |
| National contact point | Croatian Health Insurance Fund[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. All counts are claims by Croatian insured persons for care obtained abroad and are not a count of foreign patients treated in Croatia. The Commission flags a reporting inconsistency in the Croatian return, which mixes working days and calendar days, so the processing time should be read with that in mind. No typical cost range is given because no official Croatian source publishes prices paid by foreign patients. | |
Medical tourism in Croatia appears in the official European data at a very small scale and with one administrative detail that the European Commission singles out. Croatia received three requests for prior authorisation in reference year 2023, refused all three, and reimbursed nothing on that route. Its average processing time for reimbursement claims, 70 days, exceeded its own 60-day legal limit, and the Commission records both the reason and a reporting inconsistency in how Croatia measured it.
Three requests, none granted
For reference year 2023 Croatia recorded three requests for prior authorisation, authorised none and refused all three, with an amount reimbursed for authorised care of zero euro. On the unauthorised route it received 200 reimbursement requests, granted 140 and refused 60.[1]
A 30 per cent refusal rate on the reimbursement route is high by the standards of the collection, where the Union-wide figure for requests granted was about 65 per cent and most countries refused a smaller share than Croatia did. With only 200 cases, however, the rate is volatile and should not be read as a policy signal on its own.[1]
A deadline missed, and why
Croatia’s average reimbursement processing time was 70 days against a 60-day legal limit. The Commission reports the explanation given: national contact points must check whether the provider used was private or contracted, and some of the correspondence with other member states needed to establish that takes longer than 60 days.[1]
The Commission also flags that the Croatian return mixes working days and calendar days, which it identifies as a reporting inconsistency. That matters directly: a figure of 70 means something different depending on which basis it is measured, and the two cannot be compared with other countries’ figures without knowing which was used.[1]
This is a small example of a general problem in cross-border healthcare data. The underlying checks are genuinely slow because they depend on another country’s administration answering, and the measurement of that slowness is not standardised.
The framework
Croatia’s designated national contact point for cross-border healthcare is the Croatian Health Insurance Fund.[2]
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 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 Croatia 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 Croatian patients obtaining care abroad, not foreign patients treated in Croatia, for which no official Croatian count was located. The numbers are small enough that percentages computed from them carry little weight. Croatia’s commercially promoted dental and cosmetic sectors on the Adriatic coast are privately funded and appear in none of these sources; no figure for them was found and none has been estimated.
See also
- Cross-border healthcare, the framework producing the Croatian figures
- Dental tourism, a privately funded flow absent from these figures
- Medical tourism statistics, and why unstandardised measurement defeats comparison
- Medical tourism in Slovenia, the neighbouring state with a far larger claim volume
- Outbound medical tourism, the direction these figures record
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 the Croatian rows for prior authorisation and reimbursement, the zero amount reimbursed, the 70-day average processing time against the 60-day limit, the stated reason involving checks on whether providers were private or contracted and correspondence with other member states, the flagged mixing of working and calendar days, and the Union-wide grant rate 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 Croatian Health Insurance Fund as Croatia’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 citizens 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 grounds for prior authorisation in Article 8(2) were read. Retrieved 23 October 2026.
Sourcing note: this entry uses only official sources. The Commission’s own flag that the Croatian return mixes working and calendar days is reported alongside the processing time it affects, rather than the figure being presented as directly comparable with other countries’. Percentages computed from Croatia’s very small case counts are described as volatile. No official Croatian count of foreign patients treated in Croatia was located, and no figure has been estimated for privately funded treatment.