FOR PARENTS · TREATMENT ABROAD
S2 Form (formerly E112)
It is issued by the National Health Insurance House and covers the costs of planned medical treatment in a country of the European Union, the EEA, Switzerland and the United Kingdom, under certain conditions.
IN BRIEF
What you need to know in 10 seconds
When can it be requested?
After the family has obtained the medical opinion from the clinic abroad, agrees with it and wants to follow it.
What is the hardest part of this process?
Getting the medical report from the treating doctor and convincing them why you choose to follow the treatment abroad, not the one they recommended.
How long does it take to be issued?
Within a maximum of 5 working days.
ELIGIBILITY
What are the conditions?
To be eligible for reimbursement of treatment through the S2 Form, both of the conditions below must be met.
The treatment is in the basic package
The treatment for which you request the S2 Form is normally provided in Romania, i.e. it is included in CNAS’s basic services package (e.g.: chemotherapy, radiotherapy, surgery, etc.).
It cannot be provided in time
The necessary treatment cannot be provided in a timely manner in Romania, given the severity of the illness and the patient’s health condition.
HOW TO GET THE FORM
Two steps, in this order
Step 1
You find the clinic
It is the family’s responsibility to find the hospital and the specialist who can offer the patient the necessary treatment.
To identify a specialist abroad with experience in treating the patient’s type of illness, the family can turn to a patient navigator or ask other patients who have been through similar experiences.
The medical opinion is usually requested by sending the specialist abroad a short, comprehensive summary of the patient’s medical history, translated into English.
The family must be kept fully informed of how discussions with the specialist abroad are progressing.
The family is responsible for the decision on the treatment the patient will follow.
If the family chooses the treatment recommended by the specialist abroad, ask the hospital whether it can be reimbursed through the S2 Form. Almost all hospitals in Europe accept this.
Request from the hospital an official Letter of Invitation, needed when you submit the file for the S2 Form to be issued.
The letter must contain: the patient’s name, the diagnosis, the medical services needed (e.g.: chemotherapy, radiotherapy, surgery, etc.), the patient’s admission date, the estimated period for carrying out the treatment and confirmation that the hospital accepts the S2 Form.
Step 2
You submit the file
The file is submitted to the Health Insurance House (CAS) in your county of residence (where your family doctor has a contract) and must include:
Identity card or the patient’s birth certificate
The application — completed on the spot when you submit the file
The official invitation letter from the hospital (printout)
Translation of the letter into Romanian by a sworn translator (original)
The standard medical report, completed by a specialist doctor from a public hospital in Romania, explaining why the patient cannot receive treatment in time — it must be signed by the head of department and the hospital manager; it can be downloaded here
The medical file — copies of medical documents: last hospital discharge, imaging, diagnostic report, test results, etc.
Frequently asked questions
Can I pay for the treatment myself and then claim the money back?
You will not get the money back. S2 works through reimbursement between health systems.
Does S2 cover travel and accommodation?
No. Form S2 covers only the costs of hospital medical treatment.
Can I get Form S2 to have a diagnosis established?
Unfortunately, no. S2 covers treatments recommended after the diagnosis has been established.
Can I have tests done through Form S2?
No, because the eligibility conditions above are not met.
Can I choose any hospital in Europe?
Almost all hospitals in Europe accept payment for services to be settled through S2. That is why you should ask the hospital this from the start.
Can I start treatment abroad before I receive S2?
Form S2 is not issued retroactively, meaning it does not cover past hospital stays, only future ones. It is usually submitted on admission.
What does S2 cover?
It covers all procedures the patient undergoes at the hospital that issued the invitation letter, during the validity period stated on the form.
How does CAS decide the validity period of Form S2?
CAS is required to grant validity for the period specified in the invitation letter from the clinic abroad.
Is Form S2 also issued retroactively?
No. It is issued with validity for a future period.
Can the application be refused?
Yes, but the refusal must be reasoned within a maximum of 5 days and can be appealed.
Can I obtain another form?
Whenever and as often as you need, as long as you meet the conditions and submit a complete file.
If I have to stay in hospital longer than initially estimated, can I request another form?
It happens often, and yes, you can. And it is simpler than the first time.
For an extension — that is, issuing a new form that starts on the calendar day after the first one ends — the hospital abroad emails a letter directly to the CAS that issued the first form, explaining why you need to stay in hospital and requesting a new form starting on […], for a period of […]. The request should be made at least 3 days before the first form expires, so that CAS has time to issue the new one.
If, for some reason, the new form cannot start the day after the previous one ends, it is no longer an extension: the process starts over from scratch, with a new file and a new medical report. That is why we recommend that families get involved directly, so that things work between institutions and, above all, on time.
