Getting healthcare through the Cross Border Directive Scheme

The Cross Border Directive (CBD) is a scheme to get planned healthcare in another European Union (EU) or European Economic Area (EEA) member state.

The CBD only applies to healthcare that is publicly available in Ireland.

Qualifying for the CBD scheme

To apply for the CBD scheme in Ireland you must:

• be ordinarily resident in Ireland - living in Ireland and can prove you intend to live in Ireland for at least 1 year
• be entitled to public healthcare in Ireland
• qualify for the healthcare you want as a public patient in Ireland
• have a valid referral letter
• follow the CBD process

You must pay for any healthcare that you get abroad. But under the scheme you can apply to the HSE for reimbursement towards the cost of the healthcare.

The healthcare must be planned. You need a valid referral and you must qualify for the healthcare you want as a public patient in Ireland.

Check that your referral is valid

You can use your public referral letter or a letter confirming you are on a waiting list for public healthcare in Ireland.

Your referral can be to a public service in Ireland or a public or private service abroad.

The date on the referral letter must be before the date of your first appointment abroad and include:

• your name, address and date of birth
• the name and address of a hospital or service and the clinical speciality
• a summary of your condition and any diagnosis, if known
• the reason for the referral or healthcare you need
• the referring professional's signature - an electronic Healthlink referral does not need a signature

You do not have to use the consultant and hospital named in the referral letter. But your healthcare abroad must be the same medical specialty on your referral letter.

Contact the Cross Border Directive office in Ireland if you are unsure if you qualify for the CBD scheme.

Private patients

Only a GP or a consultant you see as a public patient can refer you for CBD healthcare.

You cannot use private healthcare accessed in Ireland as part of your patient pathway when using the CBD.

If you are unsure if you qualify, contact the National Contact Point.

Follow the CBD process

To claim a reimbursement you must follow the CBD process to use health services in another country:

1. Have a valid letter of referral for public healthcare from a GP or hospital consultant in Ireland.
2. Have a consultation with a healthcare provider abroad - this is called an outpatient appointment.
3. Travel abroad for healthcare.
4. Pay for any healthcare you get abroad.
5. Complete the CBD pro forma invoice with your healthcare provider abroad.
6. Apply for a reimbursement towards the cost of the healthcare abroad.

Documents you need to send with your application

If you need healthcare that involves an overnight stay in hospital, you can get prior notification before you go abroad.

Check which country can process your claim

In some cases, Ireland may not be responsible for your application or you might not be eligible for the scheme.

You may need to apply for the CBD scheme in another country if you:

• get your income from another EU or EEA country
• receive a public or state pension from another EU or EEA country
• are a dependant of someone who gets their income from another EU or EEA country

You may not be eligible for the scheme if you:

• receive income or pension from Switzerland or the UK
• pay your social security contributions in one of those countries

The rules for the scheme can be complex in these cases. If any of these apply to you, phone us on 056 778 4546 or email crossborderdirective@hse.ie.

We will let you know if you are eligible and if Ireland is responsible for your claim. If another country is responsible, we will provide you with contact details for the national contact point for the other country.

Costs covered by the CBD scheme

You can only claim a reimbursement towards the cost of your healthcare under the Cross Border Directive.

You cannot claim for:

• travel costs
• the cost of any prescription medicines you need
• translation costs

Maximum payments are based on the cost of public healthcare in Ireland.

Find out how much you can claim

The Drugs Payment Scheme (DPS) helps with the cost of prescribed medicines and some appliances. There is no means test for a DPS card.

Prescriptions from abroad

If you get a prescription from a healthcare provider abroad, you should be able to use it in Ireland.

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Visit the Your Europe website

Toolbox for cross-border healthcare - on europa.eu