Health insurance for pre-established medical treatment abroad
Waiting for treatment in Iceland
The specialist group by Iceland Health will assess whether the conditions for medical treatment abroad are fulfilled, as defined in Article 8 of the act on health insurance no. 112/2008.
The committee meets once a month. An application with the necessary information must be available so that the committee can consider whether it can be approved. Individuals can apply themselves, but then detailed medical documentation must accompany the application, see below, but it is recommended that therapist fill out the application.
If necessary healthcare services are not provided in Iceland within a medically justified time limit, taking into account the current health status of the insured person and the likely progress of the disease cf. article 20 of EC regulation no. 883/2004, cf. article 20 of national regulation no. 442/2012, which is in force in Iceland since May 2012, the waiting period and necessity must be confirmed in relation to the likely progress of the disease.
These rules apply to public schemes in the EEA, the UK and Switzerland.
Note that you must always apply for prior approval to Iceland Health, which must be available before treatment is carried out. If an application is approved, the total cost of medical treatment is paid in full, along with travel and maintenance costs.
Once the case is approved, contact Icelandair, which will arrange for the flight to be booked and the flight will be paid by Iceland Health You can apply for daily allowance for maintenance costs but no documents need generally accompany an application for daily allowance but further documentation will be requested if necessary.
The National Health Service has set thresholds for waiting times for health services in Iceland. Accordingly, the following criteria apply:
Contact with health clinic on the same day.
Interview with a healthcare professional within 5 days.
Expert inspection within 30 days.
Action/treatment with a specialist within 90 days of diagnosis.
In all cases, this includes the time that passes from the time the patient contacts healthcare services due to symptoms or from the time the need for the services in question is diagnosed. This time limit does not apply in the case of emergency services or for the diagnosis and treatment of malignancies.
It needs to ensure that the following are available:
Detailed information on waiting for action/treatment in the institutions or institutions in Iceland, which perform the actions in question or provide the treatments in question.
A certificate from a specialist physician, who also accompanies the patient after treatment abroad, with detailed justification for the fact that it is not recommended for the applicant to wait longer than the defined time, due to the potentially harmful effects that delay in treatment might have on his condition and ability to conduct daily life and work. The certificate will attempt to evaluate the distress that the patient must experience or other factors that may impair his quality of life, if treatment is delayed beyond what is stated in the certificate. It is necessary to certify clearly that the waiting period in Iceland for treatment is not medically justified.
It must be known that the hospital that provides the treatment is an approved institution and that the treatment is evidence-based. This means that the applicant doctor must guarantee and preferably demonstrate by data (other than a reference to websites or similar) that the approved healthcare institution is in existence. The treatment that is applied for must be treatment that is paid for by the social security in the country (“the country of stay”) in question.
If an application for medical treatment abroad has been approved, please note the following:
Treatment costs are paid.
Travel, maintenance and possible companion costs are paid.
Iceland Health pays the patient's fare from Iceland to the place where treatment is planned and back again. The fare is also refunded nationally according to special rules on travel costs.
If the patient is under 18 years of age, travel allowance may be paid for both parents or two closest relatives, as appropriate.
Iceland Health pays daily allowances for necessary support costs for a patient outside a hospital as well as support costs for an escort or escorts. In the case of children, Iceland Health pays full daily allowances to one parent but half to the other. Children under four years of age receive one-quarter of the daily allowance, while those between four and eleven years of age receive half the daily allowance.
Iceland Health pays only maintenance daily allowance for the days that are medically necessary to stay abroad, there is no authorization to pay for overtime or when an individual chooses to stay longer to receive services that can be obtained in Iceland.
Couples may participate in the costs of assisted reproductive technology if they cannot receive adequate treatment in Iceland. Couples participate in the costs of treatment in the same way as if assisted reproductive technology had been performed in Iceland. Full daily allowance is paid for one spouse, but half for the other during the stay outside the hospital.
If treatment is chosen at a different and more expensive location than the maritime committee has approved, Iceland Health will pay only the cost it would have borne to pay for comparable services at a cheaper location.
If circumstances are such that a healthcare professional must accompany a patient, Iceland Health will pay a travel grant to the patient.
How can you send us your applications and the necessary documents?
Send applications together with data with secure data submission via Data submission for individuals or the treating physician's Gagnagátt
Bring the application and documents to our Service Center at Vínlandsleið 16. You can get help filling out the applications there
Service provider
Iceland Health