State funding for treatment abroad: when, who decides and with which documents

When does the state consider funding treatment abroad?

The original version of Government Resolution No. 331 of 2010 said so directly: services provided abroad are not funded, except where the relevant service cannot be provided in Georgia. The current version is structured differently but keeps the same logic: when treatment abroad is requested, the commission's documents are sent to the Ministry's expert in the relevant specialty for an opinion on whether treatment outside Georgia is necessary.

In practice this means one question sits at the centre of the application: why can this treatment not be given in Georgia? The commission does not consider which clinic is better or more comfortable; it assesses whether the relevant method, equipment or expertise exists in Georgia. For laboratory and ophthalmology services the rule is even more specific: the documents are first sent to providers registered in Georgia so that they can confirm whether they can provide the same service.

Giving this question a convincing answer is the treating doctor's job: the doctor writes the medical justification and decides whether treatment abroad is needed. If the doctor is not certain on this point, the second opinion guide will help you request an independent assessment.

Four routes: which one applies to your case?

The table is based on the current versions of Government Resolutions No. 331 (2010) and No. 655 (2025). Details of the two special programmes for children are in the guide to funding a child's treatment.

How does the referral commission work?

The commission is set up at the Solidarity Fund, and its membership and working principles are set by an act of the Minister of Health. The fund handles the organisational side: it explains to applicants which documents they need, receives and registers the package, checks that it is complete and only then passes it to the commission.

The commission works in sessions. A session is quorate if more than half of the members attend, decisions are taken by a majority of those present and are recorded in minutes. The commission sets the state's share according to the applicant's status: highest, medium or assessed by income. The commission obtains income data from the Revenue Service through the National Health Agency. Exceptions can be made by decision of the commission.

How the referral programme works in general for services provided in Georgia is described in the referral programme guide. Here we cover only the specifics of treatment abroad.

Who can act as a representative

The resolution requires a copy of the identity document of the applicant or their representative, which means another person can submit the application on the patient's behalf. If the patient is already abroad or cannot visit the agency because of a serious condition, confirm the authority of the family member or lawyer with a power of attorney. State clearly in the power of attorney that the representative may submit the application, receive the decision and, if needed, appeal it. We explain how such a document is prepared, including when the patient is in another country, on the remote power of attorney service page.

Which documents does the commission require for treatment abroad?

The current version of Resolution No. 331 sets stricter requirements than usual for an application for treatment abroad. Three things are attached to the application addressed to the commission:

1. A copy of the identity document of the applicant or their representative.
2. Form IV-100/a, which clearly and in detail sets out the conclusion or full diagnosis (main disease, comorbidities, complications), past illnesses, medical history, the tests and consultations carried out and the course of the illness. For treatment abroad, the form must also contain the doctor's recommendation on this need, with ICD-10 and NCSP codes. How to check the certificate before submitting it is explained in the Form 100 guide.
3. The foreign clinic's invoice and cost estimate, translated and notarised, with a breakdown of costs.

How the cost estimate should be broken down

Foreign clinics often send the cost estimate as a single total or in their own categories. Before you order a translation, ask the clinic to rewrite the document according to these groups; otherwise the translated text will not meet the commission's requirement and you will have to have it translated again. We cover translating an invoice prepared for a funding application on the financial document translation page, and you can see an indicative price in the translation calculator.

What happens after the decision: notification, deadlines, payment

• Notification. You are notified of the decision by text message, and on request you will also receive the guarantee letter on paper. You pass the information to the foreign clinic yourself.
• Start deadline. Treatment abroad must start no later than two months after the commission's minutes. The deadline can be extended once by the same period; if treatment has not started within that time, the decision is deemed cancelled.
• Applying again. After cancellation you can apply to the commission again, and it may use the documents already submitted.
• Advance funding. If the money is allocated before treatment, the patient or their authorised representative undertakes in writing to submit a report on the work performed and proof of the costs no later than 30 calendar days after receiving the service.
• Service already received. If the service has already been received, payment is made on the basis of documents issued by the provider, which the patient or representative may submit.

Typical decisions and what each one means

Full or partial approval

The resolution expressly provides for partial approval too. In that case the minutes state the amount or share the state covers, and the rest remains with you. A partial decision is a strong argument for other sources: City Hall, a foundation or a donor can see that the state has recognised the case as necessary and has already funded part of it.

Refusal

A refusal may be based on the expert's opinion that treatment is also possible in Georgia, or on the commission's assessment that funding is not appropriate: the resolution tasks the commission precisely with determining appropriateness, taking into account the applicant's income and financial situation. Before you decide anything, ask for a written, reasoned refusal and a copy of the expert's opinion: once you know the expert's argument, the treating doctor can answer it specifically. The appeal route is in the guide to appealing a refusal.

Cancellation because the deadline has passed

This is not a refusal: the decision lapses if treatment does not start within the set deadline. The risk arises when the visa, passport and clinic date are only dealt with after the decision. So plan the logistics alongside the application.

Logistics to plan alongside the application

Two months is a short time if everything starts after the decision. Settle a few things as soon as you submit the application:

• Visa and passport. In many countries a medical visa requires an invitation from the clinic and a financial guarantee. We prepare the paperwork through our medical visa service.
• Clinic confirmation. Make sure the clinic will not change the price in the cost estimate before the decision is made and will hold a date for you within the two-month window. If you have not chosen a clinic yet, our clinic search service can help.
• Medical records. The foreign clinic needs the discharge summary, imaging reports and Form 100 in its own language. We list what the package should contain in the documents guide.
• Accompanying person. Non-medical costs are a separate group in the cost estimate, but whether they are funded depends on the commission's decision and is not guaranteed in advance.

If the commission covered only part of the cost, people turn to the municipality, charitable organisations or a medical loan for the rest.

Frequently asked questions about funding for treatment abroad