Skip to main content

We use cookies to help us improve your experience and to provide services like web chat. We also use cookies to measure the effectiveness of public health campaigns and understand how people use the website.

To find out more about cookies and how we use them, please see our privacy policy.

Apply for Cross Border Directive repayment

You can reclaim the cost of healthcare under the Cross Border Directive (CBD) up to the maximum amount of its cost in Ireland if you’re eligible for the scheme.

Read about how to qualify for the CBD scheme

You can't claim for the cost of any prescription drugs you need after your healthcare.

You won't be paid for any travel costs.

You must pay for the healthcare yourself and then apply to claim it back.

If you are having healthcare that involves an overnight stay in hospital, we advise you to apply for prior authorisation before you go abroad.

How much you can claim

You can claim repayment for whichever is the lesser:

  • the cost of your healthcare abroad
  • what the healthcare would have cost in Ireland

If the healthcare costs less abroad than it would have in Ireland you can only claim for what you paid.

Outpatient healthcare claims

The maximum you can be repaid for an outpatient consultation in a hospital abroad is €130.

Outpatient care is healthcare that doesn’t involve an overnight hospital stay.

Day-case healthcare claims

Day-case care abroad is healthcare that does not involve an overnight stay in hospital.

The HSE has a list of day-case healthcare costs in Ireland. This document is called the Admitted Patient Price List Summary (day case) (PDF, 1.39MB, 32 pages).

You can use this document to find out the maximum amount you can reclaim.

Inpatient healthcare claims

Inpatient care abroad is healthcare that involves an overnight stay in hospital.

The HSE has a list of inpatient healthcare costs in Ireland. This document is called the Admitted Patient Price List Summary (Inpatient) (PDF, 1.39MB, 32 pages).

You can use this document to find out the maximum amount you can reclaim.

If you've had inpatient care abroad, the HSE will deduct €80 per night, to a maximum of €800, from the amount you can be repaid.

You will not have to pay the €80 per night if either of the following apply:

  • You have a medical card.
  • You have already paid €800 for overnight stays in hospitals abroad or in Ireland in the last 12 months.

Repayment cost examples

The cost in Ireland is €10,000 with an €80 per night hospital charge.

If the cost in France is €11,000 and you were in hospital for 5 nights then you can claim for €9,600. This is €10,000 less the inpatient charge of €400.

If the cost in France was €5,000 and you were in hospital for 5 nights, then you can claim €5,000 as this is less than the €10,000 it would have cost in Ireland minus €400.

How to apply

To apply for repayment under the Cross Border Directive, you and your healthcare provider abroad should complete the CBD pro forma invoice.

Before leaving the hospital ask the consultant to fill in part B of the pro forma invoice.

Repayments are made only to the patient or their parent or guardian if the patient is under 18.

The executor of the patient’s estate can apply for repayment if the patient is dead.

You’re breaking the law if you enter any false or misleading information on the pro forma invoice.

If you are paid money based on false or misleading information the HSE will reclaim the money from you.

The Cross Border Directive pro forma invoice

We recommend completing a CBD pro forma invoice. This is because it has all the information we need to make a prompt repayment.

You and your healthcare provider abroad need to complete the pro forma invoice in English.

If any part of the invoice is completed in another language you’ll have to pay for and submit a certified translation.

You can’t claim for the translation cost.

Your consultant abroad must put in the correct DRG (Diagnosis-Related Group) code for your healthcare.

You can find all the correct DRG codes in:

We may check the DRG code your consultant abroad sends us. If we think it is wrong, it will be independently reviewed. If this review suggests a different code should have been used, we will use the outcome of that independent review.

To claim repayment

You must submit your:

  • completed CBD pro forma invoice
  • hospital's original invoice and receipt
  • referral letter from the GP or public consultant who referred you
  • proof of travel such as a plane ticket receipt - this is to show you travelled abroad for your healthcare

Your referral letter must be:

  • signed by your GP or public consultant - it can't be signed by their nurse or secretary
  • dated
  • named and addressed to a named doctor

When you can expect repayment

We usually aim to repay patients within 30 working days of getting all the completed documents. But currently repayments are taking a minimum of 3 months.

If you've already applied for repayment

If you've already applied for repayment you can contact the Cross Border Directive office in Ireland for an update.

Telephone:

Email: crossborderdirective@hse.ie

Appealing a decision

If your application is refused you can appeal that decision by writing to the:

General Manager
Commercial Unit of the Acute Hospitals Division
HSE
Kilcreene Office Complex,
Kilkenny
Co. Kilkenny

We recently updated this content. See the original version here

Related Content

  • Cross Border Directive Pro-forma Invoice
    PDF489KB
    To apply for repayment under the Cross Border Directive, you and your healthcare provider abroad should complete the cross border directive pro-forma invoice.
  • Admitted Patient Price List Summary (Daycase)
    PDF821KB
    Daycase treatment costs in Ireland are set out in a document called 'Admitted Patient Price List Summary- Daycase'. Use this document to find out the maximum amount you can reclaim for treatment abroad.
  • Admitted Patient Price List Summary (Inpatient)
    PDF1.39MB
    Inpatient treatment costs in Ireland are set out in a document called 'Admitted Patient Price List Summary- inpatient'. Use this document to find out the maximum amount you can reclaim for treatment abroad.

Page last reviewed: 08/11/2018
Next review due: 08/11/2021