EU legislation means Irish patients can go anywhere in the EU for medical treatment – and the HSE must foot the bill.
What do I need to know?
You have the right to receive medical treatment in another EU member state and the right to have your home country cover some or all of the costs.
How is this the case?
The European Cross Border Healthcare Directive came into force very recently. It was fully enforced in Ireland in February (2015) although part of the legislation was put through in summer 2014.
What does it mean if I need a hospital treatment, scan or procedure?
It means that you can travel to another EU country and get your treatment in a public or private hospital and the HSE must foot the bill. The HSE does not have to cover your travel expenses.
What does this new legislation cover?
Virtually all elective treatment, bar organ transplants. It includes everything from hip and heart operations to diagnostic scans. It also includes psychiatric and addiction treatment, as well as orthodontic treatment and rehabilitation. It does not cover long-term care.
The unprecedented patient rights differ from the European Health Insurance Card (formerly called the E111 for someone who falls ill suddenly) or the existing Treatment Abroad Scheme (for treatments not available in Ireland), as the new legislation pertains to planned procedures that are provided in Irish hospitals.
Do I have to be on a waiting list for a certain amount of time?
No. You don’t even need to be on a waiting list.
According to the Department of Health: “Referral for care under the Cross Border Directive can be made by a GP, a hospital consultant and certain other HSE clinicians.”
Will my doctor know about this legislation?
Don’t bank on it. Awareness is poor, albeit growing. The HSE and the government have not advertised or promoted this directive. It has been reported that there are concerns around the potential costs to the HSE.
How do I know where to go overseas, or in the North?
That’s up to you. The Department of Health said: “It will be a matter for the patient and his/her referring doctor to identify the clinician abroad and satisfy him/herself in relation to the qualifications, quality and safety of the services being availed of in the other jurisdiction.”
Explain how the HSE covers the cost?
The patient pays for the treatment and claims reimbursement from the HSE at the cost of that treatment in Ireland or the cost of it abroad, whichever is the lesser. The HSE promises to do that immediately, upon receiving the invoice.
This sounds too good to be true?
It certainly does. But the HSE and the Department of Health have both confirmed that the legislation is in place and that patients have already travelled.
Do I need prior authorisation from the HSE before travelling?
The HSE has set up a National Contact Point Office to administer and oversee implementation of this directive. Prior authorisation is not necessarily needed, but it is required for inpatient treatment/care.
However, it is highly recommended that you discuss your planned treatment with the National Contact Point Office before committing to anything.
How can I find out more?
This article first appeared in the Sunday Business Post.