The European legislation governing intra-EU patient movements across the Member States is in itself very complex. In this book, two dimensions of the legal complexity are identified: the complexity of legal rules applicable to the various scenarios of cross-border patient mobility and the complexity of the simultaneous application of legal tools. On the one hand, access to healthcare outside the Member State of residence includes three different situations to which different rules apply: access to healthcare in the competent Member State when residing outside the competent Member State; access to necessary healthcare during a temporary stay outside the Member State of residence; and access to planned healthcare outside the Member State of residence. On the other hand, these situations are currently regulated by two (if counting the case law as well, three) separate sets of rules: the social security coordination mechanism and the case law-based Patient Mobility Directive, which partly overlap and partly conflict with each other, creating doubts and legal uncertainty.

These two dimensions of legal complexity are scrutinised in the next sections to show which difficulties border-crossing patients face and how these difficulties could be tackled. The rules applicable to various scenarios of crossborder patient mobility are analysed, synthesising the provisions of the different legal tools alongside the administrative requirements and procedures which must be followed in the different scenarios. For each scenario, the starting point is the body of the Regulation. The picture is completed with what the Court concluded in its case law and the Patient Mobility Directive added to the legal framework. Without any doubt, the legislation on cross-border healthcare provision is not the only challenge for patients, the related administrative procedures are often lengthy, time-consuming and ponderous. Through these formal processes, patients are confronted with a complex legal framework and they might be easily discouraged by the administrative burden or the conditions attached to the different forms of patient mobility. Therefore, the examination of the administrative conditions and procedures cannot be left out of this analysis.

At the end of the chapter, the conflicts and defects of the recent legal and administrative framework are pointed out.