A special subgroup are the medical spas who offer treatments that are paid back by the national health insurance program.
Destination spas have been in use for a considerable time, and some are no longer used but are rather preserved as elements of earlier history; for example, Gilroy Yamato Hot Springs in California is such a historically used spa whose peak patronage occurred in the late 19th and early 20th century.
In 21 of the 27 EU countries they are very known and they have often state contracts with the ministry of health to provide a certain minimum yearly capacity of treatment places for patients.
Another example are the contracts with for example the national public transport operators to help recuperate lung capacity or change unhealthy lifestyle and food consumption behavior.
In the latter case, reimbursement by the public health care is only done after people stayed the minimum prescribed 14 to 18 days, the time necessary to provoke behavioral changes and take the healthier lifestyle choices and practices back home.