The Department of Health has introduced a Republic of Ireland (ROI) Reimbursement Scheme for a period of 12 months. This new scheme opened on 1 July 2021 and is available to ordinary residents of Northern Ireland. The scheme provides an option for those patients who may wish to access private treatment in ROI and claim reimbursement of Health & Social Care (HSC) equivalent cost. The scheme is based on the EU Cross Border Healthcare Directive.
How it works:
The eligible patient:
The treatment a patient receives in ROI under the temporary scheme is not being arranged by the HSC but by the patient and no clinical responsibility is borne by the HSC for the treatment.
In choosing to arrange access healthcare themselves, the patient is effectively stepping outside of the HSC system. At this point, the patient is taking individual responsibility for ensuring that the service they obtain is appropriate and safe within the laws of ROI (not under UK legislation). The HSC, under this scheme will not be formally commissioning services from providers abroad and therefore will not be liable for the outcome of the treatment provided.
There are some qualifiers to the right to seek ROI planned cross border treatment. The Board will reimburse treatment costs under the ROI planned treatment route provided:
ROI planned cross border healthcare applications must be authorised by the Board prior to treatment. Retrospective applications will not be considered.
The Board requires that patients seek prior approval:
There are commissioning restrictions on certain services and the Board, under Effective Use of Resources policies, do not commission certain procedures. Patients are therefore are required to contact the Board in advance of travelling to discuss obtaining prior approval, as well as information on the levels of reimbursement they can expect to receive.
The Board wishes to ensure that patients who are seeking diagnostics and treatment which is not offered by the HSC/NHS, and patients seeking treatment which is subject to conditional access for which the individual patient may not qualify, do not incur significant expense before establishing that they are not entitled to reimbursement.
There can also be major differences between the prices patients will be charged for private treatment and the equivalent NHS cost which is why the Board is operating a prior approval system.
This Scheme will not apply to:
Where the patient has opted to seek treatment under the provisions of this scheme:
The Board will:
The patient will:
The Board recommends that you should ensure that you have comprehensive medical insurance for your journey for treatment. The cost of such insurance is not reimbursable by the health service.
You should also ensure that you have a valid GHIC (Global Health Insurance Card) or EHIC for use in the event of medical emergency unrelated to the planned treatment. Please note that the GHIC or EHIC does not allow you to go abroad for the purpose of receiving planned treatment and does not cover the costs of private healthcare or services that are not part of the state healthcare system.
Download an application form here.
See Frequently Asked Questions for more information.
If you are a resident in Northern Ireland seeking to travel to ROI for treatment, please contact:
National Contact Point
Health and Social Care Board
Commissioning Directorate – Patient Travel Team
12-22 Linenhall Street
Belfast BT2 8BS
Tel: +44 (0)28 9536 3152