Member State of affiliation definition

Member State of affiliation means the Member State where the patient is an insured person;

Member State of affiliation means the Member State where the patient is an insured person or the Member State where the patient resides if this Member State is not the same as the former.

Member State of affiliation means the Member State where the patient has social security affiliation in accordance with the coordination rules laid down in Regulation (EEC) No 1408/71;

Examples of Member State of affiliation in a sentence

• This may include an assessment by a health professional or healthcare administrator providing services for the statutory social security system or national health system of the Member State of affiliation, such as the general practitioner or primary care practitioner with whom the patient is registered, if this is necessary for determining the individual patient’s entitlement to healthcare.

• The Member State of affiliation shall reimburse the costs to the insured person, which would have been paid for by its statutory social security system had the same or similar healthcare been provided in its territory.

• Where the full cost of cross-border healthcare exceeds the level of costs that would have been assumed had the healthcare been provided in its territory the Member State of affiliation may nevertheless decide to reimburse the full cost.

• In any event, it is for the Member State of affiliation to determine the healthcare that is paid for regardless of where it is provided.

• The costs of cross-border healthcare shall be reimbursed or paid directly by the Member State of affiliation up to the level of costs that would have been assumed by the Member State of affiliation, had this healthcare been provided in its territory without exceeding the actual costs of healthcare received.

• For the purposes of paragraph 4, Member States shall have a transparent mechanism for calculation of costs of cross-border healthcare that are to be reimbursed to the insured person by the Member State of affiliation.

• If no experts can be found within the Member State of affiliation or if the expert’s opinion is inconclusive, the Member State of affiliation may request scientific advice.

• It is for the Member State of affiliation to determine, whether at a local, regional or national level, the healthcare for which an insured person is entitled to assumption of costs and the level of assumption of those costs, regardless of where the healthcare is provided.

• This mechanism shall be based on objective, non-discriminatory criteria known in advance and the costs reimbursed according to this mechanism shall be not less than what would have been assumed had the same or similar healthcare been provided in the territory of the Member State of affiliation.

• National contact points in the Member State of affiliation shall provide patients and health professionals with the information referred to in Article 5(b).

More Definitions of Member State of affiliation

Member State of affiliation means* the Member State where the person is insured or has the rights to sickness benefits (also included the Member State that is competent to grant to the insured person a prior authorisation to receive appropriate treatment outside the Member State of residence or in another Member State)

Member State of affiliation means the Member State where the patient is an insured person. If the patient is legally resident in a Member State and not insured by any European social security scheme, but has a recognised entitlement to healthcare, the Member State of affiliation shall be the Member State of residence;