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Cross Border Directive - using a referral to get healthcare abroad

You can access healthcare abroad using the Cross Border Directive (CBD) in much the same way that you would access public healthcare in Ireland.

You may need to pay up front for any healthcare you get abroad. You can then apply for repayment towards the cost of your healthcare.

How you usually get public healthcare in Ireland

The typical steps you would take when getting healthcare or treatment in a public hospital in Ireland are:

  1. Visit your GP to discuss your condition.
  2. Your GP refers you to a hospital consultant.
  3. You are put on a hospital waiting list to see the consultant.
  4. You get called for a consultation with the consultant - this is called an outpatient appointment.
  5. The consultant will decide to either:
         put you on a waiting list for treatment.
         discharge you back to your GP - this means they don’t believe you need further hospital treatment.
  6. If you are on a waiting list for treatment, you will be called for hospital treatment - this is called inpatient treatment.
  7. You will then have a follow up appointment with the consultant.
  8. You will then be discharged back to your GP.

Using the CBD to get healthcare abroad

At any stage in the steps outlined above, you can decide to leave the Irish system and get healthcare abroad under the CBD.

For example:

When your GP refers you as a public patient to a public hospital in Ireland, you can use that referral to have the same healthcare abroad instead. You just need to contact the hospital abroad you want to go to and arrange an outpatient appointment.

If you are on a waiting list in Ireland, you can use your referral or waiting list letter to get healthcare abroad. 

Referral from a doctor in Ireland

You must have a referral from a GP or public hospital consultant to access most types of healthcare abroad under the CBD. Your doctor will discuss your options with you.

They will need to refer you to a specific healthcare provider abroad. But they may also refuse to do so. Your GP or consultant may refuse to refer you directly abroad if they’re:

  • unfamiliar with the service abroad
  • concerned about the quality of the service abroad
  • concerned that the service will fully meet your medical needs

But if they refer you to a public hospital in Ireland, you can use that referral to access the same healthcare abroad.

Referral letter

Your referral letter must include:

  • the name and address of a hospital consultant - you don't have to use the consultant and hospital named in the referral letter
  • your name, address and date of birth
  • your current health and any other relevant information
  • the healthcare you need
  • the GP or consultant's signature - it can't be signed by their nurse or secretary
  • the date of the referral letter

Your referring doctor in Ireland can advise you if your healthcare can be accessed under the CBD.

But if you are in doubt contact the Cross Border Directive office in Ireland. The office is known as the National Contact Point.

Referral from a doctor abroad

A GP or consultant abroad can refer you for healthcare under the CBD.

If you plan to use a referral from a doctor abroad, contact the National Contact Point.

Referral for community-based services

Your GP or consultant can refer you for community-based services.

You can also be referred for some community-based services by: 

  • Public health nurses,
  • community dentists,
  • HSE orthodontists
  • other HSE health specialists

Read more about examples of healthcare available under CBD

Referral for addiction care

There is a specific process you need to follow if you are accessing addiction care abroad.

Read information on how to access addiction care abroad (PDF, 395kb).

We recently updated this content. See the original version here

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page last reviewed: 08/11/2018
next review due: 08/11/2021