Applying for repayment

After you have paid for your healthcare with a private provider in Northern Ireland, you can apply for a repayment towards the cost under the Northern Ireland Planned Healthcare Scheme (NIPHS).

How much you can claim under the NIPHS

How to qualify for the NIPHS scheme

Completing the NIPHS pro forma invoice

To apply for repayment under the NIPHS, you and your healthcare provider in Northern Ireland should complete the pro forma invoice (PDF, 835 KB, 19 pages).

Before you leave the hospital, ask the consultant to fill in part B.

They must use the correct DRG (Diagnosis-Related Group) code.

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 in Northern Ireland 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

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.

If you paid in a different currency

If you used a currency other than Euro to pay for your healthcare, you can claim repayment based on the exchange rate you were given at the time.

But you must include proof of the exchange rate in your application, such as a bank statement or a currency exchange receipt.

Applying for repayment

Send the completed invoice and supporting documents to:

Northern Ireland Planned Healthcare Scheme,
HSE,
St Canice’s Hospital,
Kilkenny,
Co. Kilkenny

We aim to repay patients within 20 working days of getting all the completed documents. But payments may take at least 3 months.

Repayments are made only to the patient or a parent or guardian if the patient is under 18.

The executor of a patient’s estate can apply for repayment if the patient has died.

Contact the NIPHS office about a repayment

Appeal a decision on the NIPHS

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.