| Verified against primary record | |
| Prior authorisation requests (2023) | 45 received, 3 authorised, 40 refused[1] |
|---|---|
| Amount reimbursed, authorised care (2023) | EUR 24,224, about a third of the 2022 level[1] |
| Reimbursement requests (2023) | 30,426 received, 25,033 granted, 4,999 refused[1] |
| Dual assessment | Unplanned-care claims may be assessed under both the Regulation and the Directive, unless the provider is private[1] |
| Patient inflow limits | Adopted; one of two reporting states to do so, and used on zero patients in 2023[1] |
| National contact point | Patientombuddet, the patient complaints authority[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 Danish insured persons for care obtained abroad and are not a count of foreign patients treated in Denmark. The 30,426 reimbursement claims are the third largest national total in the collection and by some distance the largest relative to population, but because unplanned care can be assessed under two legal routes the figure is not confined to travel undertaken to obtain treatment. No typical cost range is given because no official Danish source publishes prices paid by foreign patients. | |
Medical tourism in Denmark combines the heaviest use of cross-border reimbursement in the European Union relative to population with the most restrictive approach to prior authorisation found anywhere in the collection. Denmark processed 30,426 reimbursement claims in reference year 2023, and in the same year refused 40 of the 45 requests for prior authorisation it received, authorising three.
Forty refusals out of forty-five
Denmark received 45 requests for prior authorisation, authorised 3 and refused 40, an approval share of under 7 per cent. Across the reporting countries as a whole, roughly 81 per cent of authorisation requests were granted, and neighbouring Slovakia granted 600 of 619. Denmark sits at the opposite end of that range.[1]
The amount reimbursed for authorised care was 24,224 euro, which the Commission records as about a third of the 2022 level. A sharp fall in both approvals and money is consistent with a tightening of practice, though the report offers no explanation and none is inferred here.[1]
Under the Directive, authorisation may be refused only on defined grounds, the principal one being that the care is available domestically within a medically justifiable time. A refusal rate approaching nine in ten therefore implies a system that treats almost all requested treatment as available at home.[5]
The largest caseload for its size
On the reimbursement route Denmark received 30,426 requests, granted 25,033 and refused 4,999. Only France and Germany reported larger totals, and both have populations many times Denmark’s, which makes Denmark the heaviest per-head user of cross-border reimbursement among the reporting countries.[1]
Part of the explanation is procedural rather than behavioural. The Commission records that in Denmark applicants for unplanned care can have their claims assessed under both the coordination Regulation and the Directive, unless the provider was private. A system that routes a single episode through two assessments will generate more recorded claims than one that does not.[1]
The Commission names the movement from Denmark to Germany among the busiest reimbursement flows in the Union, which fits the general pattern that cross-border care is overwhelmingly a neighbour-to-neighbour matter.[1]
Denmark also sits outside one of the instruments that applies elsewhere: the Commission records that Regulation 1231/2010, which extends social security coordination to certain third-country nationals, does not apply in Denmark.[1]
An adopted power to limit inflow
Denmark is one of only two reporting states recorded as having adopted limits on the inflow of patients from other member states, the other being Romania. Denmark limited zero patients in 2023.[1]
Taken with Estonia, which holds an enabling power it has never used, this gives three northern and eastern European states that legislated for the possibility of turning foreign patients away and have not needed to. It is a useful corrective to the assumption that every health system treats inbound patients as an opportunity.
Denmark’s designated national contact point is Patientombuddet, the patient complaints authority, which is an unusual choice: most states give the function to an insurance fund, a health ministry or a health agency rather than to a complaints body.[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 Denmark 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
Denmark’s large reimbursement total is inflated to an unknown degree by the dual assessment of unplanned-care claims, so it should not be read as a measure of travel undertaken to obtain treatment. The authorisation figures are small enough that the approval share, while striking, rests on 45 cases. No explanation for the fall in authorised reimbursement is given in the source and none is inferred. These figures describe Danish patients obtaining care abroad, not foreign patients treated in Denmark, for which no official Danish count was located.
See also
- Medical tourism in Germany, the destination of the busiest Danish flow
- Medical tourism in Romania, the other state recorded as adopting inflow limits
- Medical tourism in Estonia, which holds an unused power of the same kind
- Medical travel and waiting lists, the ground on which authorisation is usually refused
- Emergency healthcare abroad, the unplanned care subject to dual assessment in Denmark
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 Danish rows for prior authorisation and reimbursement, the amount reimbursed and the note that it fell to about a third of the 2022 level, the statement that applicants for unplanned care may be assessed under both the Regulation and the Directive unless the provider is private, the record that Denmark is one of two countries adopting patient inflow limits and limited zero patients, the note that Regulation 1231/2010 does not apply in Denmark, the naming of the Denmark to Germany reimbursement flow, the Union-wide authorisation grant rate and the Slovak comparator 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 patient complaints authority as Denmark’s national contact point was read directly, together with the different kinds of body designated by other states. 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 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 dual assessment of unplanned-care claims is reported prominently because it inflates Denmark’s reimbursement total by an unknown amount, so that total is not presented as a measure of medical travel. No explanation is offered for the low authorisation approval share or the fall in reimbursed amounts, because the source gives none. No official Danish count of foreign patients treated in Denmark was located, and no figure has been estimated.