Ireland’s Cross Border Directive (CBD) scheme can reimburse eligible planned healthcare in another EU or EEA country. You pay for the treatment first and apply to the HSE afterwards. Repayment is limited, so the amount you spend and the amount you receive back may differ. HSE scheme guidance
For someone considering care abroad, the first questions are whether this is the right scheme, what referral is needed and how much must be funded before any repayment arrives.
Who is the Irish scheme for?
The HSE says applicants must qualify for public healthcare in Ireland and have lived there for at least a year, or intend to do so. The treatment must be healthcare available through Ireland’s public system. A public-patient referral is required; the HSE describes referral routes through a GP or consultant. Eligibility and referral guidance
The Irish CBD scheme covers EU/EEA destinations. It does not cover treatment in the UK; Northern Ireland has a separate arrangement. If another country is responsible for your healthcare cover, check responsibility with the HSE before assuming the Irish scheme applies. HSE country and eligibility rules
CBD, EHIC and TAS answer different needs
The comparison below uses the schemes’ stated purposes and funding routes. It is not a ranking or an individual eligibility assessment.
| Scheme | Purpose and payment route |
|---|---|
| Cross Border Directive | Eligible planned care abroad. The patient pays first, then claims reimbursement subject to a ceiling. |
| European Health Insurance Card (EHIC) | Medically necessary state-provided care during a temporary stay, on local terms. It does not cover a trip made for treatment. |
| Treatment Abroad Scheme (TAS) | A separate route for treatment unavailable in Ireland, or unavailable within the medically necessary time. It requires referral by an Irish public-hospital consultant and HSE approval before travel. |
TAS uses the S2 route with an eligible public hospital accepting that form. Its listed destinations include the UK and Switzerland as well as EU/EEA countries. The HSE marks its TAS page as under review, so confirm current arrangements directly before making a booking. Treatment Abroad Scheme
How much can you claim back?
The CBD ceiling is the lower of the treatment cost abroad and the equivalent cost in Ireland’s public system. The HSE excludes travel, accommodation, translation and intermediary fees from repayment. Reimbursement rules
For illustration, if eligible treatment cost €2,400 abroad and the relevant Irish public-system amount were €1,800, the reimbursement ceiling would be €1,800. The treatment-cost difference would be €600, before travel and other excluded expenses. These are illustrative figures, not a price quote or a prediction for any procedure.
For inpatient and day-case care, the HSE uses treatment information and diagnosis-related group (DRG) codes. The applicable amount depends on the treatment and how it would be delivered in Ireland; published prices can change. A provider’s advertised price cannot establish the HSE’s final repayment. How costs are assessed
What can be checked before travelling?
The HSE requires an outpatient consultation before inpatient or day-case treatment. For inpatient care it must be in person; for day-case care it may be in person, by phone or by video. Outpatient consultation requirements
For inpatient or day-case treatment, the HSE offers optional prior notification. It can indicate eligibility to apply and an estimated repayment amount. The exact amount is determined after treatment, and a repayment application is still required. Before you go abroad
This is useful for understanding the likely funding gap, but it is not the same process as TAS approval. Read the HSE’s documentation requirements before paying a deposit or relying on a reimbursement estimate.
What the repayment application needs
The HSE asks for a completed claim form, the relevant referral or public waiting-list evidence, and proof of payment for the treatment. The overseas provider completes its section of the form. The referral letter must be dated before the outpatient consultation. Payment must be made directly to the provider. If any part of the proof of payment is completed in another language, the HSE requires a certified translation. Apply for repayment
Processing notice, checked 12 October 2026: the HSE says it normally aims to pay within 30 working days of receiving the necessary documents, but currently warns that high demand is causing longer waits. That target should not be treated as a guaranteed repayment date. Current repayment guidance
Where to resolve an uncertainty
Use the HSE Cross Border Directive office for questions about eligibility, prior notification or an existing claim. Its contact page also explains the appeals route: an appeal must be made within three months of receiving the decision.
Before committing money, establish the scheme, referral route, likely reimbursement ceiling and costs you must fund yourself. Those administrative checks help clarify the arrangement; they do not decide whether a treatment is clinically appropriate.