Skip to main content

Warning notification:Warning

Unfortunately, you are using an outdated browser. Please, upgrade your browser to improve your experience with HSE. The list of supported browsers:

  1. Chrome
  2. Edge
  3. FireFox
  4. Opera
  5. Safari

Getting healthcare through the Cross Border Directive Scheme


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.

The Cross Border Directive (CBD) is a scheme to get planned healthcare in another European Union (EU) or European Economic Area (EEA) member state.

Countries in the EU and EEA

EU countries are:

Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden

EEA countries are:

Iceland, Liechtenstein, Norway

The CBD only applies to healthcare that is publicly available in Ireland.

Other schemes to get healthcare abroad

The CBD scheme is different to other schemes to access healthcare outside of Ireland, such as:

If the treatment you need is publicly available in Ireland, you can access it through the:

You can access this healthcare in the same way you'd get public healthcare in Ireland.

You can no longer use the CBD to access healthcare in the UK. This is because the UK left the EU on 31 December 2020.

Claiming for healthcare you started to get in the UK before 2021

Qualifying for the CBD scheme

To apply for the CBD scheme in Ireland you must:

  • be ordinarily resident in Ireland - living in Ireland and can prove you intend to live in Ireland for at least 1 year
  • be entitled to public healthcare in Ireland
  • qualify for the healthcare you want as a public patient in Ireland
  • have a valid referral letter
  • follow the CBD process

You must pay for any healthcare that you get abroad. But under the scheme you can apply to the HSE for reimbursement towards the cost of the healthcare.

The healthcare must be planned. You need a valid referral and you must qualify for the healthcare you want as a public patient in Ireland.

Public healthcare process in Ireland

The typical steps to get healthcare or treatment in a public hospital in Ireland are:

  1. Visit your GP to discuss your condition.
  2. Your GP refers you to a hospital consultant and you are put on a hospital waiting list to see the consultant.
  3. You have a consultation with the consultant - this is called an outpatient appointment.
  4. The consultant either puts you on a waiting list for treatment or discharges you back to your GP if you do not need further hospital treatment.
  5. If you are on a waiting list for treatment, you are called for hospital treatment - this is called inpatient treatment.
  6. You have a follow-up appointment with the consultant.
  7. You are discharged back to your GP.

At any stage you can decide to leave the Irish system and get healthcare abroad under the CBD.


If you get your income from another country, you may not qualify for the CBD in Ireland.

Check which country can process your claim

Check that your referral is valid

You can use your public referral letter or a letter confirming you are on a waiting list for public healthcare in Ireland.

Your referral can be to a public service in Ireland or a public or private service abroad.

The date on the referral letter must be before the date of your first appointment abroad and include:

  • your name, address and date of birth
  • the name and address of a hospital or service and the clinical speciality
  • a summary of your condition and any diagnosis, if known
  • the reason for the referral or healthcare you need
  • the referring professional's signature - an electronic Healthlink referral does not need a signature

You do not have to use the consultant and hospital named in the referral letter. But your healthcare abroad must be the same medical specialty on your referral letter.

Contact the Cross Border Directive office in Ireland if you are unsure if you qualify for the CBD scheme.

Referral from a doctor abroad

A GP abroad can refer you for healthcare under the CBD.

If you plan to use a referral from a doctor abroad, contact the National Contact Point.

Referral for community-based services

Your GP or consultant can refer you for community-based services.

You can also be referred for some community-based services by: 

  • public health nurses
  • community dentists
  • HSE orthodontists
  • other HSE health specialists

Private patients

Only a GP or a consultant you see as a public patient can refer you for CBD healthcare.

You cannot use private healthcare accessed in Ireland as part of your patient pathway when using the CBD.

If you are unsure if you qualify, contact the National Contact Point.

Follow the CBD process

To claim a reimbursement you must follow the CBD process to use health services in another country:

  1. Have a valid letter of referral for public healthcare from a GP or hospital consultant in Ireland.
  2. Have a consultation with a healthcare provider abroad - this is called an outpatient appointment.
  3. Travel abroad for healthcare.
  4. Pay for any healthcare you get abroad.
  5. Complete the CBD pro forma invoice with your healthcare provider abroad.
  6. Apply for a reimbursement towards the cost of the healthcare abroad.

Documents you need to send with your application

If you need healthcare that involves an overnight stay in hospital, you can get prior notification before you go abroad.

Check which country can process your claim

You may need to apply for the CBD scheme in another country if you:

  • get your income from another EU or EEA country
  • are a dependant of someone who gets their income from another EU or EEA country

Contact the National Contact Point for the other country to check if they are responsible for your claim. They can also tell you if you are entitled to a reimbursement.

Download a list of national contact points for cross-border healthcare (PDF, 808 KB, 9 pages)

If the UK or Switzerland is your competent state, you cannot use the CBD scheme. This is when you pay your social security contributions in the UK or Switzerland. If you are unsure or need help, contact the National Contact Point in Ireland.

Costs covered by the CBD scheme

You can only claim a reimbursement towards the cost of your healthcare under the Cross Border Directive.

You cannot claim for:

  • travel costs
  • the cost of any prescription medicines you need
  • translation costs

Maximum payments are based on the cost of public healthcare in Ireland.

Find out how much you can claim

The Drugs Payment Scheme (DPS) helps with the cost of prescribed medicines and some appliances. There is no means test for a DPS card.

Prescriptions from abroad

If you get a prescription from a healthcare provider abroad, you should be able to use it in Ireland.


Help us to improve our service by taking part in the surveys below. The content will load in a new browser window.

Your Europe. This webpage is part of an EU quality network.

Page last reviewed: 1 May 2024