This content is currently being reviewed. Read about your rights in cross-border healthcare under EU law and the regulations for cross-border healthcare under Irish law.
To apply for a reimbursement under the Cross Border Directive (CBD):
- Complete the CBD pro forma invoice (PDF, 886 KB, 19 pages) in English with the healthcare provider abroad - ask the consultant to fill in part B of the pro forma invoice before you leave the hospital.
- Gather your supporting documents.
- Post the form and documents to the CBD office.
We aim to reimburse patients within 20 working days of getting all the completed documents. But currently payments are taking a minimum of 2 to 3 months.
Reimbursements 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 a reimbursement if the patient has died.
Documents you need to send
You need to provide:
- a completed CBD pro forma invoice (PDF, 886 KB, 19 pages)
- a copy of a referral letter or a letter confirming you are on a waiting list for public healthcare in Ireland
- proof of payment and proof that you paid the healthcare provider abroad directly
Proof of payment
Your proof of payment must include:
- patient’s name and address
- name, address and phone number of the healthcare provider
- the treatment provided
- date of treatment
- the amount paid
- a breakdown and description of all treatment charges and VAT, if relevant
If any part is completed in another language, you must submit a certified translation. You cannot claim for the translation cost.
Proof you made the payment
You must also provide proof that you paid the healthcare provider directly.
Examples of proof you made the payment include your:
- bank or credit card statement
- credit or debit card receipt
- copy of an electronic fund transfer (EFT) from your account to the healthcare provider’s account
- copy of a bank draft paid to the healthcare provider
- cash receipt
We must be able to identify the payee (the healthcare provider) and the payer (you). The name of the healthcare provider and the amount paid must match the information in your proof of payment.
How much you can claim
You can claim reimbursement for whichever is the smaller amount:
- the cost of your healthcare abroad
- what the healthcare would have cost in the public system in Ireland
If the healthcare costs less abroad than it would in Ireland, you can only claim for what you paid.
We may check the DRG code your consultant abroad sends us. If we think it is wrong, it will be independently reviewed. If the review suggests a different code should have been used, we will use the outcome of that independent review.
Outpatient healthcare claims
Outpatient care is healthcare that does not involve an overnight hospital stay. The maximum you can be repaid for an outpatient consultation in a hospital abroad is €194.
There are different types of outpatient appointments such as x-rays, CT scans, biopsy or MRI scans. If you have more than 1 outpatient appointment on the same day, the maximum you can claim is €194.
If your consultation took place:
- before 1 March 2021, the maximum you can claim is €130
- between 1 March 2021 to 1 May 2023, the maximum you can claim is €178
Day case healthcare claims
Day case care is healthcare that does not involve an overnight stay in hospital.
You can use patient price lists to find out the maximum amount you can claim.
If you had your treatment on or after 1st July 2024 use:
The rate for cataract procedures will not change until 1 September 2024.
If you had your treatment from 1 May 2023 to 30 June 2024, use:
If you had your treatment from 1 July 2022 to 30 April 2023, use:
Inpatient healthcare claims
Inpatient care abroad is healthcare that involves an overnight stay in hospital.
You can use patient price lists to find out the maximum amount you can claim.
If you had your treatment on or after 1st July 2024 use:
If you had your treatment from 1 May 2023 to 30 June 2024, use:
If you had your treatment from 1 July 2022 to 30 April 2023, use:
If you had inpatient care abroad before 17 April 2023, the HSE will deduct €80 per day, to a maximum of €800, from the amount you can be repaid.
You will not have to pay the €80 per day if any 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 12 months before your treatment abroad.
- You had inpatient care abroad after 16 April 2023.
Read more about hospital charges.
Claiming for previous healthcare in the UK
You can no longer use the CBD scheme to access healthcare in the UK. This is because the UK left the EU on 31 December 2020.
But if you started your healthcare in the UK (including Northern Ireland) before 2021, you may still be able to apply for a reimbursement.
You can apply if your:
- healthcare began before 31 December 2020
- upcoming treatment was booked before 31 December 2020
- healthcare was due to happen in 2020, but was cancelled and rescheduled to 2021 by the provider. This may have been due to the COVID-19 pandemic
In each case, you must provide evidence that your healthcare began or was scheduled to begin before 31 December 2020.
This may include:
- confirmation that the healthcare was provided before 31 December 2020, such as a medical report, invoice or receipt
- a scheduled appointment letter dated in 2020
If you used a different currency
If you used a different currency than Euro to pay for your healthcare, you can claim a reimbursement based on the exchange rate you were given at the time.
You must include proof of the exchange rate in your application such as a bank statement or a currency exchange receipt.
Misleading information
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.
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