Case C-538/19: Judgment of the Court (Fourth Chamber) of 6 October 2021 (request for a preliminary ruling from the Curtea de Apel Constanţa — Romania) — TS, UT, VU v Casa Naţională de Asigurări de Sănătate, Casa de Asigurări de Sănătate Constanţa (Reference for a preliminary ruling — Social security — Sickness insurance — Regulation (EC) No 883/2004 — Article 20(1) and (2) — Medical treatment received in a Member State other than that in which the insured person resides — Prior authorisation — Conditions — Requirement for a report prescribing treatment, drawn up by a doctor of the national public sickness insurance scheme — Prescription, by way of a second medical opinion, drawn up in a Member State other than that in which the insured person resides, of an alternative treatment which has the advantage of not causing a disability — Full reimbursement of the medical expenses incurred in respect of that alternative treatment — Freedom to provide services — Article 56 TFEU)
Date: 2021-10-06
Institutions: Court of Justice
Subjects: EU Member State, disabled person, freedom to provide services, health insurance, hospital expenses, medical report, public insurance, residence, therapeutics








C_2021481EN.01001001.xml










29.11.2021   


EN


Official Journal of the European Union


C 481/10






Judgment of the Court (Fourth Chamber) of 6 October 2021 (request for a preliminary ruling from the Curtea de Apel Constanţa — Romania) — TS, UT, VU v Casa Naţională de Asigurări de Sănătate, Casa de Asigurări de Sănătate Constanţa
(Case C-538/19) (1)

(Reference for a preliminary ruling - Social security - Sickness insurance - Regulation (EC) No 883/2004 - Article 20(1) and (2) - Medical treatment received in a Member State other than that in which the insured person resides - Prior authorisation - Conditions - Requirement for a report prescribing treatment, drawn up by a doctor of the national public sickness insurance scheme - Prescription, by way of a second medical opinion, drawn up in a Member State other than that in which the insured person resides, of an alternative treatment which has the advantage of not causing a disability - Full reimbursement of the medical expenses incurred in respect of that alternative treatment - Freedom to provide services - Article 56 TFEU)
(2021/C 481/13)
Language of the case: Romanian

Referring court

Curtea de Apel Constanţa

Parties to the main proceedings


Applicants and appellants: TS, UT, VU

Defendants and respondents: Casa Naţională de Asigurări de Sănătate, Casa de Asigurări de Sănătate Constanţa

Operative part of the judgment

Article 20 of Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems, as amended by Regulation (EC) No 988/2009 of the European Parliament and of the Council of 16 September 2009, read in conjunction with Article 56 TFEU, must be interpreted as meaning that an insured person who has received, in a Member State other than that in which he or she resides, treatment that is among the benefits provided for by the legislation of the Member State of residence, is entitled to full reimbursement of the expenses for that treatment, under the conditions laid down in that regulation, where that person could not obtain authorisation from the competent institution in accordance with Article 20(1) of that regulation on the ground that, even though the diagnosis and the need to administer treatment as a matter of urgency had been confirmed by a doctor belonging to the sickness insurance scheme of his or her Member State of residence, that doctor had prescribed him or her a different treatment as compared to the treatment which that person chose in accordance with a second medical opinion, drawn up by a doctor in another Member State, and which, unlike the former treatment, does not give rise to a disability.


(1)  OJ C 357, 21.10.2019.