Apply for Cross Border Directive repayment
You can reclaim the cost of treatment under the Cross Border Directive (CBD) up to the maximum amount of its cost in Ireland if you’re ‘ordinarily resident’ in Ireland.
Ordinarily resident means that you're living in Ireland and are going to remain living in Ireland for at least one year.
You can not claim for the cost of any prescription drugs you need after your treatment.
You will not be paid for any travel costs.
There is no way to borrow the cost of the treatment from the HSE. You must pay for the treatment yourself and then apply to claim it back.
How much you can claim
You can claim the cost of your treatment abroad up to the amount the treatment would cost in Ireland.
If the treatment cost less abroad than it would have in Ireland you can only claim for what you paid.
Inpatient treatment costs in Ireland are set out in a document called a 'ready reckoner' document.
Use this document to find out the maximum amount you can reclaim for treatment abroad.
If the treatment you are going to get abroad isn't in the ready reckoner, contact the National Contact Point office
Phone: 056 778 4547 or 056 778 4546 or 056 778 4556.
If you're getting inpatient care abroad (treatment that involves an overnight stay in hospital), 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 in the last 12 months.
An outpatient consultation in a hospital abroad is repaid at a maximum of €130.
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 for Cross Border Directive repayment
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 invoice.
Repayments are made only to the patient or the parent, guardian or spouse if the patient is under 18 or incapacitated, for example physically or mentally unable to complete the form.
If the patient is dead at the time of applying for repayment, then the executor of the patient’s estate can apply. They will need power of attorney to make a claim.
You’re breaking the law If you enter any false or misleading information on your invoice the CBD. If you are paid money based on false or misleading information the HSE will reclaim the money from you.
How to complete the Cross Border Directive invoice
You and your healthcare provider abroad need to complete the invoice in English. If any part of the invoice is completed in another language you’ll have to pay for 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 treatment. You can find all DRG codes in the ready reckoner document.
Submit your CBD pro-forma invoice with the:
- hospital's original invoice and receipt
- referral letter from the GP or consultant who referred you - this could be a doctor in Ireland or abroad
- proof of travel such as a plane ticket receipt
- vendor form
You don't have to complete the CBD invoice to apply for repayment.
But a fully completed CBD invoice has all the information we need to make a prompt repayment.
When you can expect repayment
We aim to repay patients within 20 working days of getting all the completed documents.