Cross Border Directive - before you go abroad
Before you travel for healthcare abroad you should:
- make sure you are eligible for the Cross Border Directive (CBD) scheme
- consider applying for prior authorisation
- consider getting your medical records to bring with you
- make sure you have travel insurance
You should also read the guide on applying for Cross Border Directive repaymentbefore you get healthcare abroad so you understand:
- if the healthcare you're getting is covered under the CBD
- how much of the healthcare cost you can claim back
Prior authorisation is confirmation from the Cross Border Directive office in Ireland that you:
- have followed the correct process to access healthcare abroad under the CBD
- will be eligible to claim repayment towards the cost of your healthcare
Prior authorisation is optional. You don’t have to apply for it.
But if you are travelling abroad for inpatient care we advise you to apply for prior authorisation. Inpatient care is treatment that involves an overnight stay in hospital.
Benefits of prior authorisation
Before you travel abroad you’ll have:
- confirmation that you're eligible to claim repayment towards the cost of your healthcare
- an indication of how much of the cost of your healthcare you can claim back from us
It also gives you time to decide if you:
- can afford the healthcare upfront or can secure the funding
- are comfortable with the consultant and the hospital abroad
- are willing to go ahead if there is a shortfall between the cost of the healthcare abroad and how much you can claim back from us. You will be be responsible for paying the shortfall
How to apply for prior authorisation
To apply for prior authorisation you must submit:
- a valid referral
- a completed application form
- proof that you have travelled abroad for your first appointment with the consultant, in person
The application form
You and your consultant must fully complete and sign the form.
The consultant must make a note of the correct DRG (Diagnosis-Related Group) code for the treatment you are getting. They must put this on the form.
The consultant can get the correct DRG code from one of two documents:
- Inpatient treatment costs in Ireland are set out in a document called the 'Admitted Patient Price List Summary (Inpatient)' (PDF, 1.39MB, 32 pages).
- Day case treatment costs in Ireland are set out in a document called the 'Admitted Patient Price List Summary (Day case)' (PDF, 802KB, 15 pages).
These documents will also help to give you an indication of how much you can claim back from us for the healthcare you receive.
Once you and your consultant have completed the prior authorisation application form you must send it and the supporting documents to:
The National Contact Point Office
Cross Border Directive
St Canice’s Hospital
Decision on prior authorisation
We usually take about 20 working days to decide on your application for prior authorisation.
If we approve your application, you can then go abroad to get your healthcare knowing you will be able to seek repayment towards the cost of the healthcare.
If your healthcare changes
Prior authorisation is given for the healthcare you apply for.
On the day of your healthcare, your healthcare may change. The consultant may decide you need:
- extra healthcare
- different healthcare
The actual healthcare you have may be different from the one you got prior authorisation for.
If this happens, you will only be eligible to be repaid for the actual healthcare you get.
If you don't apply
You don't need prior authorisation to access healthcare abroad under the CBD. Prior authorisation is optional.
You can still get healthcare and claim repayment towards the cost of that healthcare once you are eligible and meet certain conditions
You might need to provide your healthcare provider abroad with your current medical records.
You should bring your records with you as well as information on any medicine you’re taking and any relevant test results.
Check with the GP or consultant who referred you or the doctor who’s treating you abroad about what information you need to bring.
Ask your GP or hospital in Ireland for your medical records.
We recommend that you take out travel insurance before you go abroad.
You should also take your European Health Insurance Card (EHIC)with you.
We recently updated this content. See the original version here