If an individual needs to undergo medical treatment that is not available in Iceland. A doctor applies for Iceland Health to contribute to the cost and confirms the necessity of treatment based on the probable progression of the disease.  Individuals can apply themselves, but then all documents from doctors must be available.  You must always apply for and get approval before starting treatment. If the application is approved, Iceland Health will pay:  

• Treatment costs. 

• Travel expenses. 

• Living expenses. 

• Accompanying costs (if a doctor says that an escort is necessary).  

The conditions are as follows: 

• It is very necessary that the individual receives the medical treatment. 

• The medical treatment is not available in Iceland. 

• The medical treatment is accredited. 

An expert group at Iceland Health assesses whether the conditions are met. The committee meets once a month, and it is important that all information and documents accompany the application so that the committee can decide on it.  The patient chooses Icelandair and contacts the airlines who request a payment guarantee to Iceland Health  It is possible to apply for per diem benefits as well. Further documentation is requested if needed. Health insurance may decide that a specialist doctor working abroad will provide the patient with the treatment at a hospital in Iceland. 

If an individual needs to undergo medical treatment for which there is too long a wait in Iceland. A doctor applies for Iceland Health to contribute to the cost and confirms the wait and necessity based on the probable progression of the disease.  Individuals can apply themselves, but then all documents from doctors must be available.  You must always apply for and get approval before starting treatment. If the application is approved, Iceland Health will pay:  

• Treatment costs. 

• Travel expenses. 

• Living expenses. 

An expert group at Iceland Health assesses whether the conditions are met. The committee meets once a month and it is important that all information and documents accompany the application so that the committee can make a decision on it.  The patient chooses between Icelandair or Play and contacts the airlines who request payment guarantees to Iceland Health. 

Thresholds for waiting times: 

• Contact with health care centre: same day. 

• Consultation with a primary care physician: within 5 days. 

• Examination by a specialist: within 30 days. 

• Surgery/treatment by a specialist: within 90 days of diagnosis. 

The waiting time is from the time an individual contacts health services due to symptoms or from the time the need for services is identified.  This time limit does not apply to emergency care or to the diagnosis and treatment of malignancy. 

It must be ensured that the following are available: 

• Detailed information on waiting for surgery or treatment at the institutions or clinics in Iceland that perform the service. 

• A certificate from a specialist doctor with detailed reasoning as to why the individual cannot wait for surgery or treatment.  

• A doctor who submits an application must justify that the institution abroad and the treatment are recognized and paid for by the social security system of that country.  

• Treatment costs are paid. 

• Travel expenses, living expenses and possible accompanying person costs are covered. 

• Health insurance pays the patient's fare from Iceland and back again. Domestic fares are also refunded in accordance with special rules on domestic travel expenses. 

• If the patient is under 18 years of age, a travel allowance may be paid for both parents or two immediate relatives. 

• Health insurance pays per diem payments for the necessary living expenses of the patient outside the medical institution and the living expenses of the accompanying person or accompanying persons. In the case of children, Iceland Health pays per diem payments in full to one parent and half to the other. Children under the age of 4 receive a quarter of the per diem allowance, while those aged 4 to 11 receive half per diem allowance. 

• Health insurance only pays subsistence per diem payments on the days when it is medically necessary to stay abroad, it is not permitted to pay excess days or when an individual chooses to stay longer in order to receive services that can be obtained in Iceland.  

• It is permissible to contribute to the cost of artificial insemination of couples if it is not possible to provide satisfactory treatment in Iceland. Couples contribute to the cost of treatment in the same way as if artificial insemination had taken place in Iceland. Full per diem payments are paid for approved artificial insemination treatments for one spouse and half for the other spouse if there are medical grounds during the stay outside the hospital. 

• If treatment is chosen at a different and more expensive location than was approved, Iceland Health will only pay the cost that it would have had to pay for comparable services at a cheaper location. 

• If circumstances are such that a healthcare professional needs to accompany a patient, Iceland Health will pay a travel allowance to him/her. 

If certain conditions are met, health insured individuals can use health care services in EEA countries, the United Kingdom and Switzerland rather than in Iceland.  

Condition: 

• Similar services must be subsidized by Iceland Health. 

• Health insurance then pays the same amount as the service costs in Iceland. 

• Health insurance does not cover travel expenses, living expenses or accompanying person costs.  

You must apply for approval from Iceland Health in advance if: 

• When treatment requires hospitalization for at least one day. 

• When treatment involves a particular risk to the patient.  

• When there is reason to doubt the quality of the service applied for.  

Health insurance processes applications as quickly as possible. In the case of a rare disease, Iceland Health can request an expert assessment. 

See Regulation.  

Data submission - important to read  

When applying for payment participation, the following documents must be submitted to Iceland Health: 

• Application for reimbursement of foreign medical expenses. 

• Itemised, numbered recognised invoice from the service provider's accounting system. 

• Payment confirmation. 

• Doctor's letter (especially applicable in the case of admissions). 

Health insurance has the authority to request further documentation if necessary. 

Iceland Health recommends that you always request to receive all documents in English, as the institution may require that case documents be translated by a certified translator and Iceland Health does not pay for that. 

• Send applications along with data with secure data submission through the Data Submission of Individuals or the Data Portal of the Treating Physician. 

• Bring your application and documentation to our customer service centre. There you can get help filling out an application. 

Only available in Icelandic