According to the Order of the Minister of Health no. 50/2004 – regarding the methodology for referring certain categories of patients for treatment abroad, with subsequent amendments and completions, the initiation by the County Public Health Directorates of the procedure for obtaining approval for treatment abroad is done only after the patient has gone through and exhausted all levels of medical care in the country and there is a recommendation from the highest-level specialist physician that the patient needs treatment that cannot be performed in Romania.

The referral for treatment abroad is made for patients registered with a family physician, who have gone through all levels of medical assistance, namely primary and specialized medical care, and who have been hospitalized in medical units providing high-quality professional and technical services, but whose health has not been restored. Exceptions are infants aged 0 – 1 year for whom the file can be prepared immediately after the diagnosis of the condition in a medical unit within a university center, without the need to go through all these stages.

The person requesting the referral for treatment abroad or their legal representative or relative (husband/wife, relative up to the fourth degree) will submit the patient’s medical documents (hospital discharge ticket, medical letter, investigation results, recommendation from the attending physician regarding treatment abroad, etc.) together with an application from the patient to the public health directorate in the territorial area where the patient, legal representative, or relative resides, accompanied by copies of their identity documents.