Buying medicinal products and foodstuffs for special medical purposes in another EU member state
Reimbursement of costs of medicinal products
You can claim reimbursement of costs of a medicinal product you purchased abroad for medicinal products and foodstuffs for special medical purposes (hereinafter: foodstuffs) you are entitled to under compulsory health insurance and which are available on the Slovenian market, but you purchased it in another EU Member State or in Slovenia on the basis of a EU prescription - you purchased it abroad because you cannot get it in Slovenia due to disrupted supply on the Slovenian market.
You can claim reimbursement of purchase costs of a medicinal product with:
- a green prescription in electronic or paper form, signed by an accredited physician in Slovenia,
- a prescription, prescribed by a healthcare professional in another EU Member State.
To purchase a medicinal product abroad, the doctor must issue you a green prescription on paper (and not a white one, which you must pay for yourself), as we do not yet have a system to digitally exchange documents with other countries.
When may you request a green prescription on a paper document from a licensed doctor?
You may request a green prescription on paper from a doctor:
- when a prescription is issued without an electronic version,
- as a replacement on paper, if it had already been issued in electronic form, but the medicinal product has not yet been administered in full.
When the replacement green prescription on paper is issued, the doctor will annul the electronic prescription. The electronic prescription is annulled regardless whether it can be renewed or not and whether the medicinal product has not been yet administered in full.
Where and how to claim reimbursement of the costs of medicinal products and food purchased abroad?
You can claim reimbursement of costs of a medicinal product you purchased abroad with an application which you submit via online form or by mail or in person at the regional unit or office of the ZZZS.
Reimbursement of costs of medicinal products, purchased in an EU Member State
The following also applies to the reimbursement of prescribed foodstuffs purchased in an EU Member State.
You are entitled to reimbursement of the purchase costs of a medicinal product, if you are entitled to the medicinal product under the compulsory health insurance in Slovenia and it is available on the Slovenian market, yet you purchased it in another EU Member State or in Slovenia based on an EU prescription issued in accordance with relevant regulations, for an appropriate quantity which may be issued in a certain time period and in accordance with the time period, within which the prescription must be submitted to a pharmacy. It is important that the medicine is prescribed and purchased abroad in accordance with the regulations that apply to the prescription and obtaining of the medicine in a Slovenian pharmacy.
Deadline for purchasing the medicinal product after the prescription date
To be eligible for reimbursement, you must purchase the medicinal product within the validity period of the prescription or in accordance with regulations for obtaining medicinal products in a Slovenian pharmacy (second or third paragraph of Article 204 of the Regulations) or within the validity period of a renewable prescription. The validity period of a prescription applies for green prescriptions as well as EU prescriptions.
If you are claiming reimbursement based on a replacement green prescription on a paper document, the validity period for purchasing medicinal products and foodstuffs in another EU Member State begins on the date the electronic prescription was issued, and not on the date the replacement green prescription on a paper documents was issued, which is prescribed instead of an electronic prescription.
Application and annexes
If you want to claim reimbursement for the cost of a medicinal product you purchased abroad, submit an application with the following documents:
- application - can be a letter or form with your data or the data of the person for which you are claiming reimbursement, the purpose of the application,
- prescription or EU prescription,
- if you are claiming reimbursement of costs of the medicinal product on the basis of an electronic prescription, state so in your application,
- if you are claiming reimbursement on the basis of an EU prescription, you must also submit medical records with a diagnosis and the opinion of the doctor who issued the EU prescription; the ZZZS may also request other documents of you, necessary for the decision-making process,
- invoice of the pharmacy, and
- data on your bank account.
If the EU prescription or other documents are submitted to the ZZZS in a foreign language which the ZZZS official does not understand, you are obliged to submit a translation in the Slovenian language at your own cost upon request of the ZZZS.
Application form for reimbursement of purchase costs of a medicinal product:
Application for reimbursement of purchase costs of a medicinal product
Amount of cost reimbursement for medicinal products
Insured persons are entitled to claim reimbursement of the costs of medicinal products in the amount of their price which the ZZZS would cover if it were issued in Slovenia, but not exceeding the actual costs of the medicinal product.
Reimbursement of costs of medicinal products and foodstuffs purchased abroad because they are unavailable in Slovenia due to supply disruptions
The following also applies to the prescribed foodstuffs.
You are entitled to reimbursement of costs of a medicinal product purchased abroad, if the product is unavailable on the Slovenian market and that the rules for prescribing medicine, the amount that may be prescribed and dispensed in a certain period of time, the limitations of prescribing and dispensing and the period during which the prescription must be submitted to the pharmacy are taken into account. It is important that the medicine is prescribed and purchased abroad in accordance with the regulations that apply to the prescription and obtaining of the medicine in a Slovenian pharmacy.
Insured persons may claim reimbursement of costs of a medicinal product on the basis of a green prescription or an EU prescription if two conditions are met:
- condition: that during the period of validity of the prescription referred to in the second or third paragraph of Article 204 of the Regulation or during the period of validity of the renewable prescription, it was not possible to provide the medicinal product in the Slovenian pharmacy due to a supply disruption and cannot replace it with another medicinal product, or a similar statement regarding the relevant foodstuff.
- condition: the medicine is purchased abroad within the time limit that applies to the purchase of the medicine in a Slovenian pharmacy.
Information on the unavailability of prescribed medicine will be obtained by a ZZZS official in the decision-making process.
Deadline for purchasing the medicinal product after the prescription date
To be eligible to claim reimbursement of purchase costs of a medicinal product you must purchase the medicinal product abroad within the validity period of the prescription, as if you would obtain the medicine in a Slovenian pharmacy.
If you can pick up the medicinal product again at a Slovenian pharmacy within the specified deadline, you may also pick it up (and not purchase it) at a Slovenian pharmacy.
Application and annexes
If you want to claim reimbursement of the costs of a medicinal product you purchased abroad, submit an application with the following documents:
- application - can be a letter or form with your data or the data of the insured person for which you claim reimbursement, the purpose of the application;
- statement of the insured person that he/she claims reimbursement of costs of the medicinal product due to a supply disruption;
- EU prescription or prescription based on which the medicinal product was purchased;
- if you are claiming reimbursement of costs of the medicinal product on the basis of an electronic prescription, state so in your application; Information on electronic prescription will be obtained by a ZZZS official;
- invoice from the pharmacy for the purchased medicinal products and
- data on your bank account.
Application form for reimbursement of purchase costs of a medicinal product:
Application for reimbursement of purchase costs of a medicinal product
Amount of cost reimbursement for a medicinal product purchased abroad
Insured persons are entitled to a reimbursement of purchase costs of the medicinal product in the amount of the actual cost of the product in the country in which it has been purchased.
Information on ZZZS prescriptions and EU prescriptions
ZZZS prescription
This prescription presents a ZZZS document for prescribing medicinal products and foodstuffs the ZZZS classifies on a list, and magisterial preparations from the List of prescription magisterial preparations prescribed to an insured person by a licensed doctor in Slovenia. Only one medicinal product or foodstuff may be prescribed with one prescription and only for one person.
The prescription consists of an administrative and medical part. The administrative part of the prescription entails data on the user, the doctor, the person who pays for the medicinal product and other relevant data. The medical part of the prescription entails the name, form, strength and quantity of the medicinal product, the dosage, method of application and eventual other relevant data. The prescription also includes identification data of the healthcare professional who prescribed the document (by stating his personal name, professional qualification, direct contact data - email and telephone number or fax number).
Detailed instructions on how to fill out the prescription document are provided in Instructions for filling out the document Prescription and the document Prescription for personal use
EU prescription
EU prescription is a paper document for prescribing medicinal products and foodstuffs that a healthcare professional in another EU Member State, who is authorised to prescribe such products or foodstuffs, prescribes to an insured person.
