Apply for reimbursement

To apply for a reimbursement under the Cross Border Directive (CBD):

  1. Complete the CBD pro forma invoice (PDF, 285 KB, 9 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.
  2. Gather your supporting documents.
  3. Post the form and documents to the CBD office.
Information:

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 must send us your:

  • completed CBD pro forma invoice (PDF, 285 KB, 9 pages)
  • hospital's original invoice and receipt
  • referral letter from the GP or public consultant who referred you in Ireland
  • proof of travel such as a plane ticket receipt - this is to show you travelled abroad for your healthcare
  • proof of direct payment to the hospital abroad such as a bank or credit card statement or bank transfer (EFT)
Examples of proof of payment

Other examples of proof of payment include:

  • cash register receipt
  • credit or debit card receipt
  • copy of the electronic fund transfer (EFT) from your account to the account of the hospital abroad
  • copy of the bank draft paid to the hospital abroad

If any part of the invoice is completed in another language, you must submit a certified translation. You cannot claim for the translation cost.

Information:

You must pay the hospital abroad for your healthcare directly. You cannot claim reimbursement if someone else makes the payment on your behalf. For example, a relative, friend or medical tourism company.

Planning your payment to the hospital abroad

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 €178.

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 €178.

If your consultation took place before 1 March 2021, the maximum is €130.

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 1 July 2022, use:

If you had your treatment from 1 August 2020 to 30 June 2022, 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 1 July 2022, use:

If you had your treatment from 1 August 2020 to 30 June 2022, use:

If you've had inpatient care abroad, 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 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.

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.

Appeal a decision

If your application is refused, you can appeal that decision in writing.

A/Assistant National Director,
Commercial Unit of the Acute Hospitals Division,
HSE,
Office no. 3,
Kilcreene Office Complex,
Kilkenny

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Page last reviewed: 5 October 2022
Next review due: 5 October 2025