| Verified against primary record | |
| Prior authorisation requests (2023) | 619 received, 600 authorised, 7 refused[1] |
|---|---|
| Reimbursement requests (2023) | 17,977 received, 15,652 granted, 1,489 refused[1] |
| Amount reimbursed, authorised care (2023) | EUR 788,856[1] |
| Dominant destination | Czechia, which dominates Slovak authorisation requests[1] |
| Change in 2023 | A new prior notification system was introduced[1] |
| National contact point | Healthcare Surveillance 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 Slovak insured persons for care obtained abroad and are not a count of foreign patients treated in Slovakia. The authorised and refused figures do not sum to the number received, because the Commission records that requests may be decided in a later year. No typical cost range is given because no official Slovak source publishes prices paid by foreign patients. | |
Medical tourism in Slovakia is, in the official European data, overwhelmingly a story of Slovaks being treated in Czechia. Slovakia reported 619 prior authorisation requests for reference year 2023, of which 600 were authorised, and 17,977 reimbursement requests, making it one of the heaviest users of the cross-border healthcare Directive in the Union relative to its size. The Commission names the movement from Slovakia to Czechia as the busiest authorisation flow in the entire Union.
The busiest flow in the Union
For reference year 2023 Slovakia recorded 619 requests for prior authorisation, of which 600 were authorised and 7 refused, with 788,856 euro reimbursed for authorised care. On the unauthorised route it recorded 17,977 reimbursement requests, of which 15,652 were granted and 1,489 refused.[1]
Two features stand out. The authorisation approval rate is among the highest reported, with 600 of 619 requests granted and only 7 refused. And the destination is concentrated: the Commission states that Slovak authorisation requests are dominated by care in Czechia, and names Slovakia to Czechia as the busiest prior authorisation flow in the Union and among the busiest reimbursement flows as well.[1]
Czechia and Slovakia formed a single state until 1993 and share a closely related language and a common medical tradition. A near-single-destination flow with an approval rate above 95 per cent describes the continuation of established referral patterns across a new border, rather than patients shopping internationally for care.
Slovakia’s 17,977 reimbursement requests are the third largest national figure in the collection, behind France and Germany and ahead of Poland, despite Slovakia having a population a fraction of theirs.[1]
A new notification system
The Commission records that Slovakia introduced a new prior notification system in 2023, as did Lithuania. A notification requirement is lighter than authorisation: the patient informs the insurer rather than seeking permission.[1]
Because the change took effect in the reference year itself, the 2023 Slovak figures straddle two administrative regimes, and year-on-year comparison with earlier or later data should be made with that in mind.[1]
Slovakia’s designated national contact point is the Healthcare Surveillance Authority, the regulator responsible for supervising health insurance and healthcare provision.[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 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 Slovakia 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. Slovakia’s 619 authorisation requests sit well above that proportion of its own caseload.[3]
Limits of the evidence
These figures describe Slovak patients obtaining care abroad. No official Slovak count of foreign patients treated in Slovakia was located, and none has been estimated. The counts are claims rather than individuals, the authorised and refused totals do not reconcile with requests received because decisions can fall in a later year, and the administrative change during 2023 limits comparison across years.
See also
- Medical tourism in Czechia, the destination that dominates Slovak cross-border care
- Language affinity and medical tourism, a plain factor in this flow
- Cross-border healthcare for border communities, the pattern these figures largely reflect
- Government-funded treatment abroad, the category the authorised cases fall into
- Clinical referral, the mechanism behind a 97 per cent approval rate
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 Slovak rows for prior authorisation and reimbursement and the amount reimbursed, the statement that Slovak authorisation requests are dominated by care in Czechia, the naming of the Slovakia to Czechia flows as the busiest in the Union, the introduction of a new prior notification system in 2023, and the caveat that requests may be decided in a later year 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 Healthcare Surveillance Authority as Slovakia’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 concentration of Slovak cross-border care on a single destination is reported as the Commission states it, and the historical and linguistic explanation is offered as explanation rather than as a sourced finding. No official Slovak count of foreign patients treated in Slovakia was located, and no figure has been estimated. The mid-year administrative change is flagged because it limits comparison across years.