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 to obtain approval for treatment abroad is made only after the patient has gone through and exhausted all levels of medical care in the country and there is a recommendation from the specialist doctor at the last level that the patient needs a treatment that cannot be performed in Romania.

Referral for treatment abroad is made for patients registered on the list of a family doctor, who have gone through all levels of medical assistance, namely primary specialized medical assistance, and who have been hospitalized in medical units that provide high quality professional and technical medical services, but whose health has not been restored. Exceptions are infants aged 0-1 year for whom the file can be drawn up immediately after the condition is diagnosed in a medical unit within a university center, without the need to go through all these stages.

The person requesting referral for treatment abroad or his/her legal representative or caregiver (spouse, up to IVth degree relative) shall submit the patient’s medical documents (hospital discharge note, medical letter, results of medical investigations, the attending doctor’s recommendation for treatment abroad, etc.) together with an application from the patient to the public health directorate in whose territorial area the patient, legal representative, or caregiver resides, accompanied by copies of their identity documents.