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Treatment Abroad Scheme or Cross Border Directive?
Ireland has two schemes for public patients who need treatment in another country, and they work very differently. This page sets them side by side in plain words, so you can see which one fits your situation.
Facts last checked:
Official sources
Two schemes for two different situations
The Treatment Abroad Scheme is for treatment that is not available in Ireland, or not available in the time normally needed for your condition. A public hospital consultant who is treating you applies for you, and the HSE must approve the treatment before you travel.
The Cross Border Directive is for planned treatment that is available in the Irish public system, at a public or private hospital you choose in another European Union or European Economic Area country. Your GP or a consultant who sees you as a public patient refers you, you pay the hospital, and the HSE pays you back afterwards.
The two schemes side by side
| Treatment Abroad Scheme | Cross Border Directive | |
|---|---|---|
| The treatment | Not available in Ireland, or not in the time normally needed for your condition | Available in the Irish public system |
| Who refers you | A public hospital consultant who is treating you and has assessed you in the two weeks before applying. GP referrals are not accepted. | Your GP, or a consultant who sees you as a public patient |
| Approval before you travel | Required. Do not book appointments before the decision. | Not required. You can send an optional prior notification form. |
| Where | The European Union, the European Economic Area, the United Kingdom and Switzerland | The European Union and the European Economic Area |
| The hospital | A recognised hospital that accepts the S2 form (also called the E112) | Any public or private hospital you choose |
| Paying for the treatment | The approved treatment is covered through the S2 form | You pay the hospital first. The HSE pays you back the lower of the price and the Irish public cost. |
| Travel and accommodation | Not covered. The scheme may help with a reasonable basic air or sea fare. | Not covered |
| How long it takes | The HSE aims to decide on a complete application within 15 to 20 working days | The HSE paid refunds in 45 days on average in 2024 |
Northern Ireland is no longer covered by the Cross Border Directive, since the United Kingdom left the European Union. The HSE runs a separate scheme for treatment there, the Northern Ireland Planned Healthcare Scheme.
Which one fits you
If your treatment is available in Ireland and your problem is the wait, the Cross Border Directive is usually the route. You do not need to be on a waiting list or to have waited any length of time, and you choose the hospital.
If your consultant says the treatment is not available in Ireland, or that you cannot wait for it as long as you would have to here, ask them about the Treatment Abroad Scheme. Only your consultant can apply for you, and the approval comes before you travel.
Where Ablement fits in
Ablement helps with the Cross Border Directive only. We find the hospital, arrange the consultation and the treatment, and prepare your claim to the HSE with you. The hospital pays us, so our help costs you nothing. The rules are explained in full on Your rights.
The Treatment Abroad Scheme is arranged by your consultant and the HSE. We do not apply for it, and we are not part of the HSE.
Kaare Beck-Fischer
Chief Executive Officer