Under the Health Insurance Act, reimbursement may be considered when an insured person has an urgent need for a recognized medical treatment that cannot be provided in Iceland.

Such cases are often referred to as “treatment abroad cases” and involve an individual being referred overseas for a specific diagnostic procedure or treatment that is not available domestically. The purpose of this arrangement is to ensure access to necessary specialized healthcare services when they are not available in Iceland. However, these provisions generally do not apply to long-term treatment or ongoing follow-up care abroad.

The assessment of such cases is based on professional and economic considerations in accordance with applicable legislation and internationally recognized practices. Cases are generally handled in cooperation with Landspítali – The National University Hospital of Iceland, as the country's most specialized healthcare institution. Assessments are based on expert opinion confirming that the need for treatment is urgent, that the treatment is evidence-based and justified in terms of both benefit and cost, and that it is not possible or cost-effective to provide the treatment in Iceland. It is also important that the application is supported by the specialist team responsible for treating the relevant disease or condition.

In the assessment process, consideration is given to scientific evidence, clinical guidelines, the experience of other countries, and the status of the treatment within the public healthcare systems of the countries with which Iceland most commonly compares itself.

Iceland Health also obtains any documentation and expert opinions necessary to make an informed decision in each individual case. Iceland Health places strong emphasis on ensuring that decisions regarding treatment abroad are based on a solid professional foundation, evidence-based knowledge, and a clear legal framework, with the objective of securing access to necessary healthcare services for insured individuals while safeguarding the interests of both patients and society as a whole.