Scope of the national agreement (national referral agreement)
The national agreement sets out the conditions that apply for a person to receive care outside the local county health authority. The agreement covers care following a local county health authority referral, emergency care and childbirth, other forms of care the patient has selected outside the local district, medical services, assistance, transport and travel. The national agreement in these respects, chapters 2 to 7 inclusive, applies if these services are not regulated by a local agreement within the region or between county health authorities. Chapter 8 however is obligatory.
The national agreement presupposes that care is provided by:
- the county health authority
- a care provider with a care agreement, a care provider whose activities are covered by the Swedish payment of medical costs act (SFS 1993:1651) or the act covering payment of physiotherapy costs (SFS 1993:1652).
National referral agreement
If you cannot be treated within a reasonable period of time by your local county health authority you have the right to receive treatment from another county health authority or private doctor who has an agreement with your local authority. Would you like to know more about the national referral agreement? To search for information from your local county health authority click here.
A patient’s local county health authority covers the costs of care provided outside the county following a referral from the local county health authority according to the following regulations.
- Each county health authority determines who has the right to refer patients for health care and treatment according to the agreement.
- A patient referred on the initiative of the patient’s local county health authority can be referred further at the cost of the local authority by a doctor eligible to issue such referrals at the clinic the patient has been referred to if this involves care or treatment specified in the referral.
- A referral for care or treatment to be provided by another county health authority applies to both inpatient and outpatient treatment. The referral may stipulate however that it only applies to outpatient treatment. Stipulations that limit the possibilities of carrying out medically justified examinations or therapies cannot however be made in the referral.
- The referral, which confers cost liability onto the referring county health authority, should contain information about the medical problem and possible therapy. In addition to the rules given here, particular regulations may apply that are stipulated on the referral form. The referral is valid for one year from the date of issue if not stated otherwise.
Other care selected by the patient outside of the county
The patient’s local county health authority will cover the costs of care selected by the patient that is provided outside the county according to the following.
- Outpatient and inpatient care for pregnancy termination.
- The patient should be offered the opportunity to select primary care provided by another county authority as well as outpatient care for specialist therapy in accordance with the patient’s local county authority’s referral rules. If the patient seeks outpatient care for specialist therapy and/or physiotherapy, according to the section above, the local county health authority will only cover the costs of care provided by the other county health care provider if the local county health authority referral regulations are met. When more expensive therapy is involved a prior approval from the local county health authority is required according to the regulations in chapter 4.4.
- Home medical care or therapy. A condition is that an agreement about the care provided is reached as soon as possible with the local county health authority.
- 4.4 The patient should be offered the choice of inpatient care provision by another county health authority at a hospital within the county health care system or as an outpatient for specialist therapy once the patient’s care needs have been determined by the local county health authority. In the case of more expensive treatments a prior approval from the local county health authority is also required.
In the case of more expensive treatments some county health authorities/regional health authorities require a prior approval from the patient’s local county health authority. The patient’s local county health authority covers the costs of the therapy itself, but not additional costs such as travel etc. Normally the patients themselves must find the alternative care provider.
There are also entirely private alternatives where the clinic can be contacted directly. Therapy costs in such cases are covered entirely by the patient, or alternatively may be covered by a private health insurance that includes surgical BPH treatment.