| Verified against primary record | |
| Prior authorisation system | None[1] |
|---|---|
| Reimbursement requests (2023) | 20,793 received, 22,265 granted, 1,436 refused[1] |
| Scope of the received figure | Combines Directive and Regulation cases, which cannot be told apart on receipt[1] |
| Scope of times and amounts | Directive cases only[1] |
| Average processing time | 96 days, against a 90-day limit[1] |
| National contact points | Two: Forsakringskassan and Socialstyrelsen[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. More claims were granted than received, which the Commission attributes to requests carried over from the previous year, so the figures are not a within-year balance. The received total mixes two legal routes while the processing times and amounts cover only one of them, meaning the numerator and denominator of any Swedish rate describe different populations. All counts are claims by Swedish insured persons for care obtained abroad and are not a count of foreign patients treated in Sweden. No typical cost range is given because no official Swedish source publishes prices paid by foreign patients. | |
Medical tourism in Sweden is recorded at one of the highest volumes in the European Union, with 20,793 cross-border reimbursement claims in reference year 2023, and on a basis that the European Commission itself describes as unable to separate two different legal routes. Sweden operates no prior authorisation system, settles claims slightly outside its own deadline, and designates two national contact points rather than one.
A large figure on an ambiguous basis
Sweden received 20,793 reimbursement requests in reference year 2023, granted 22,265 and refused 1,436. More were granted than received, which the Commission attributes to requests carried over from the previous year, a pattern it also records for Norway and Poland.[1]
The more consequential caveat concerns what is being counted. The Commission records that Sweden’s received requests combine cases arising under Directive 2011/24/EU with cases arising under the social security coordination Regulations, and that the two cannot be told apart at the point of receipt. It also records that Sweden’s reported processing times and amounts cover only Directive cases.[1]
That combination makes the Swedish return internally mismatched in a specific way. The volume figure describes a wider population than the time and money figures do, so dividing one by the other produces a number that corresponds to nothing. Sweden’s 20,793 cannot be placed alongside, for example, Slovenia’s 3,189 as though both counted the same thing.
Sweden also has no prior authorisation system, which places it with Estonia, Finland, Norway, Cyprus, Lithuania and Latvia among the states that declined a power the Directive permits but does not require.[1]
Where Swedish patients go
The Commission names the movements from Sweden and from Norway to Spain among the busiest reimbursement flows in the Union. This is not the neighbour-to-neighbour pattern that dominates most European cross-border care; it describes northern residents obtaining care in a southern country, which is consistent with long winter stays and with resident or semi-resident populations rather than with deliberate travel for treatment.[1]
Spain, for its part, 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 only ten Directive claims of its own for 2023. The Swedish and Norwegian flows are part of what explains that asymmetry.[3]
Two contact points
Sweden designates two national contact points for cross-border healthcare: Forsakringskassan, the social insurance agency, and Socialstyrelsen, the national board of health and welfare. Most member states designate one body, and Lithuania is the only other state in this series recorded with a split designation.[2]
The European Court of Auditors found that fewer than half of national contact point websites explained that two separate legal routes to treatment abroad exist, and that fewer than 20 per cent of citizens surveyed in 2015 were aware of their cross-border rights. A system that cannot itself distinguish the two routes when a claim arrives, and that splits the advisory function between two agencies, is unlikely to improve on that.[3]
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 Sweden were not retrievable for this article.[4]
Limits of the evidence
Sweden’s headline volume is the least comparable large figure in the collection, because it mixes two legal routes by the Commission’s own account while its other reported measures do not. The within-year arithmetic does not close, since decisions carried over from the previous year are counted as grants. These figures describe Swedish patients obtaining care abroad, not foreign patients treated in Sweden, for which no official Swedish count was located, and no figure has been estimated for privately funded treatment of foreign patients.
See also
- Medical tourism in Spain, the destination of one of the busiest Swedish flows
- Healthcare for international retirees, a likely component of the Sweden to Spain flow
- Medical tourism in Norway, named in the same flow to Spain
- Medical tourism in Lithuania, the other state with two designated contact points
- Cross-border healthcare, and the two routes Sweden cannot separate on receipt
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 record that Sweden has no prior authorisation system, the Swedish row showing 20,793 requests received, 22,265 granted and 1,436 refused, the statement that received requests combine Directive and Regulation cases that cannot be told apart on receipt, the statement that processing times and amounts cover only Directive cases, the 96-day average against the 90-day limit, the attribution of the excess grants to carry-over from the prior year as also recorded for Norway and Poland, and the naming of the Sweden and Norway to Spain reimbursement flows 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 two Swedish national contact points, the social insurance agency and the national board of health and welfare, was read directly, together with the single-body designations of other member 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, the 2016 incoming patient figure for Spain, the finding that fewer than half of national contact point websites explained the two routes, and the 2015 awareness finding 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 rate has been computed from the Swedish figures, because the Commission records that the volume figure and the time and amount figures cover different populations. The grant total exceeding the received total is reported with the Commission’s own explanation rather than corrected. No official Swedish count of foreign patients treated in Sweden was located, and no figure has been estimated.