IF you are entitled to public health services in Ireland, you may choose to access those services in another member state of the European Union (EU) or European Economic Area (EEA), which also includes Iceland, Liechtenstein and Norway, and be repaid the cost if you meet the requirements.
How does the scheme work?
In the same way that you would be referred to public health services in Ireland, you must be referred to the health service you require abroad. This may be, for example, by your GP (family doctor) or public hospital consultant. In the case of some community-based services the appropriate referral could be by a Health Service Executive (HSE) professional such as a public health nurse, community dentist or HSE orthodontist.
You pay the costs of treatment and then apply for a refund when you return to Ireland. The healthcare must be publicly funded and available in Ireland but the referral may be to a public or private health service in the other country.
You should make sure that the service you are seeking to access abroad is covered by the Cross-Border Healthcare Directive.
Your referring clinician can advise you about this but if you are in doubt you can contact the National Contact Point in Ireland to check.
Can I access healthcare in Britain or Northern Ireland?
You can no longer use the Cross-Border Healthcare Directive to access healthcare in Britain. The Northern Ireland Planned Healthcare Scheme is a temporary scheme that allows you to receive healthcare in Northern Ireland in a similar way to the Cross-Border Healthcare Directive. The healthcare must be publicly available in Ireland. You must pay for the healthcare and then claim the cost from the HSE.
What healthcare treatments are available under the scheme?
Examples of healthcare that is available under the scheme include:
- Day, in-patient and out-patient care in acute hospital services, including psychiatric services
- Community-based out-patient care
- Dental and orthodontic services (with some exceptions, such as dental screening services in schools)
- Speech and language services
- Occupational therapy services (with some exceptions, such as assessment for aids at home)
- Psychology services
- Physiotherapy services
- Disability services
- Ophthalmic services
- Mental health services
- Methadone programme
- Addiction care
Some health services are not included, for example, organ transplantation and long-term care such as nursing home care.
How do I apply for the refund of costs?
To get a refund of the costs that you pay for your treatment, you and your healthcare provider abroad must complete the HSE Cross-Border Healthcare Directive Pro-Forma Invoice and submit it with the invoice from the healthcare provider and receipt. The refund will only be made to the patient (or to the parents of a child patient).
The HSE has published the refund amounts for different treatments. Treatments are listed according to a code – you can get the code for your treatment from the healthcare professional who has referred you. If you prefer, or if your treatment is not listed, you can get details of the refund rates from the National Contact Point.
The maximum refund for a hospital outpatient consultation is €130. If you have more than one consultation on the same day with consultants in the same speciality, the daily limit is €130. For in-patient treatment, the charges for public in-patients in public hospitals in Ireland will apply. These charges will be deducted from the amount of the refund.
What are the contact details for the National Contact Point office?
It is based at St Canice’s Hospital, Dublin Road, Kilkenny. The telephone number is 056 7784546 and the email is [email protected]