EU Cross Border Directive

Irish residents can now avoid the long HSE waiting lists by having their Operation Abroad.

The EU Cross Border Healthcare Directive (CBD) allows Irish patients to travel abroad for planned medical treatment in other EU countries.

Providing an alternative healthcare solution, the CBD, means patients no longer need to live in pain or be on a mountainous waiting list with their condition worsening.  

To access healthcare in an EU country, the patient asks for a referral letter from their GP, and the patient can arrange travel.

Once the medical treatment is undertaken, the patient can apply for a refund of costs from the HSE. The reimbursement covers all consultation, treatment, and rehabilitation costs up to the amount it would cost the HSE to perform the treatment in Ireland. 

The final reimbursement amount is limited to a total of whichever treatment costs less – either the costs of your healthcare abroad or what the healthcare would have cost in Ireland.

Qualifying for the Cross Border Directive scheme

There are some regulations to follow to qualify for a refund through the Cross Border Directive (CBD).

You must:

•    Be ordinarily resident in Ireland
•    Be entitled to public healthcare in Ireland
•    Travel abroad for the healthcare
•    Be referred by your GP or hospital consultant in Ireland
•    Provide a copy of a letter confirming you are on a waiting list in Ireland
•    Apply for repayment of your treatment costs after you have paid for it

What healthcare is available under the scheme?

•    Inpatient & Outpatient Hospital Services – Surgical Procedures such as hip and knee replacements, Gallbladder, Hernia, Cataracts and tests and scans
•    Outpatient Care - Dental, Ophthalmic, Orthodontics and much more.

How does it work?

You will need to follow these guidelines for undergoing medical treatment in another EU country and claiming your reimbursement from the HSE:

•    As somebody who qualifies for Irish public healthcare, request a letter of referral from a public health professional
•    Arrange a consultation with a healthcare provider abroad
•    Travel abroad for your healthcare and pay for your procedure
•    Complete the CBD pro forma invoice with your healthcare provider abroad.
•    Apply for repayment towards the cost of healthcare abroad.

Getting a Referral to Travel Abroad for Treatment

Your referral letter from your GP or hospital consultant must include:
•    the name and address of a hospital consultant
•    your name, address and date of birth
•    your current health status and any other relevant information about your condition
•    the healthcare you need
•    the GP or consultant's signature
•    the date of the referral letter

If your referral is to a public hospital in Ireland, you can also use that same referral for your overseas treatment. You will not need to be referred to a specific overseas healthcare provider.

Arranging your Treatment Abroad

Once you have a referral letter, you can make arrangements to travel abroad and begin your healthcare procedure.

You will need an initial consultation at the clinic or hospital where you will receive treatment before undergoing your surgical procedure.

As part of the rules of the CBD, the initial consultation has to be in person. You can't have your outpatient consultation with a consultant abroad by video call.

After your consultation. you can then undergo the treatment.

Repayment from the HSE - HSE Refund for Treatment in Europe

Upon your return to Ireland, you apply to the HSE to claim repayment for the healthcare costs you paid abroad.

You can not claim reimbursement for a) the costs of any medicines you may need and b) any travel costs such as flights or hotel accommodation.

Applying for Reimbursement

To apply for repayment under the Cross Border Directive, you and your overseas healthcare provider must complete the HSE CBD Pro-forma Invoice.

Before leaving the hospital, ask the consultant to fill in part B of the Pro-forma invoice.

If any part of the invoice is completed in another language you’ll have to pay for and submit a certified translation. The cost of translation is not claimable.

You will need to submit the below documents:

  • Original invoice(s) from the hospital abroad.
 Original receipt(s) from the hospital abroad.

  • Proof of travel eg flight receipt

  • Completed Pro-forma invoice (optional, but in the absence of this the patient will need to provide documentation from the hospital abroad as to the DRG code of the treatment provided).

You will usually receive reimbursement within 30 working days.

Prior Authorisation

Prior authorisation is optional. You do not have to apply for it.

To secure confirmation that you will receive the reimbursement, you will need to have followed the procedures. You also need to submit:

a)    A completed application form
b)    A referral letter from your GP or consultant and;
c)    Proof of having travelled abroad for a face-to-face consultation with the specialist..

A decision typically takes between 15 and 20 working days after the CBD Office receives the completed application form.


Contact Us

If you are now ready to end the frustration of being on a long waiting list for surgery in Ireland and want to access treatment in Europe by some of the most experienced surgeons in superb private healthcare facilities, it's time to take action.

Our Cross Border Department can help guide you through all the steps to get you the treatment you need quickly.

For further details, ring 0800 081 0018 or 00 44 (1) 61 236 3211 or email: