Direct Anterior Approach for Total Hip Replacement

The Cross Border Directive

The Cross Border Directive scheme qualifies you to get planned healthcare in another European Union (EU) or European Economic Area (EEA) member state.The Cross Border Directive only applies to healthcare that is publicly available in Ireland.

Qualifying for the EU Cross Border Directive 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 (Healthcare Abroad can help you with this)
  • Follow the CBD process (Healthcare Abroad guide you in this process)
  • You must pay for any healthcare that you get abroad. Under the scheme you can apply to the HSE for reimbursement towards the cost of the healthcare. (We can help you apply for a loan if needed)

If you receive your income in another country, you may not qualify for the CBD in Ireland. An important point on this is a UK pension. Many Irish citizens have a joint UK Irish pension. If your Irish pension is larger; you are still entitled to travel under the Cross-Border Directive.

Check that your referral is valid

You can use your public referral letter or waiting list letter to get healthcare abroad. Healthcare Abroad will provide you and your GP with a template to use. 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.

Your letter must include:

  • The name and address of a hospital consultant
  • Your name, address and date of birth
  • A summary of your condition and any diagnosis, if known
  • The healthcare you need
  • The GP or clinical referrer’s signature – it cannot be signed by their nurse or secretary
  • The date of the referral letter – the letter must be issued before your first appointment abroad

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. You are still entitled to use the Cross-Border directive regardless of whether you have private health insurance or not.

Follow the CBD process

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

  • Have a valid letter of referral for public healthcare from a GP or hospital consultant in Ireland.
  • Have a consultation with a healthcare provider abroad – this is called an outpatient appointment. We organise this for you.
  • Travel abroad for healthcare – We will meet you in the airport both in Ireland and Abroad.
  • Pay for any healthcare you get abroad. Pay either through the Credit Unions or with your Debit card. Never pay with cash.
  • Sign the CBD pro-forma invoice that Healthcare Abroad will give you.
  • We submit your documentation on your behalf to apply towards the cost of the treatment abroad.
  • Keep proof that you travelled abroad i.e your Boarding passes.

Applying in another country

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.

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 please give us a call and we will be more than happy to help you.

Costs covered by the Cross Border Directive

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 (Healthcare Abroad look after this for you)

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

The Drugs payment scheme with the HSE helps with the cost of prescribed medicines and some appliances. you and your family only have to pay a maximum of €80 each month for approved prescribed drugs and medicines, and certain 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.


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We've helped thousands of Irish patients like you. Those who are stuck on waiting lists in Ireland, travelled abroad for treatment - cared for by us.