Long waiting lists in Ireland can delay essential treatments like hip or knee replacements, cataract surgery, or cardiac care. The EU Cross Border Directive (CBD) offers an alternative: it allows Irish residents to receive planned healthcare in another EU or EEA country, such as Spain, and later apply for repayment for the treatment costs from the Health Service Executive (HSE).
In this article, we’ll explain how the Directive works in general terms, what types of treatments Irish patients commonly receive in Spain, and how Ribera Care International supports patients throughout the process.
All information below follows the official HSE guidance. For the most accurate and updated details, please, consult the official website: Cross Border Directive Scheme.
Understanding the EU Cross Border Directive
The EU Cross Border Healthcare Directive (2011/24/EU) gives EU citizens the right to access planned medical care in another member state and then apply for repayment from their home country’s public health service. For Irish patients, this means you can choose to receive a planned medical treatment in another EU or EEA country and request repayment for the treatment from the HSE afterwards. You must pay the provider abroad directly and then submit all required documentation for reimbursement.
It’s important to note that travel, accommodation, and translation costs are not reimbursed, and that you can only claim repayment for treatments that are publicly available in Ireland.
Who can use the scheme
According to the HSE, you can apply under the Cross Border Directive if:
- You live in Ireland or intend to live there for at least one year.
- You are entitled to public healthcare in Ireland.
- You have been referred for treatment by a GP or consultant you have seen as a public patient.
If your income or state pension comes from another EU or EEA country, different rules may apply. The HSE advises contacting them directly if you are unsure which country should process your application.
Most Popular Treatments Among Irish Patients
While the EU Cross Border Directive does not set a fixed list of procedures, the HSE confirms that patients may seek treatment abroad for any healthcare service that is publicly available in Ireland. In practice, certain specialties have become especially popular among Irish residents travelling to Spain for faster access and specialist care.
Based on our experience, the following specialties are among the most frequently requested by Irish patients who travel abroad for medical care, particularly to Spain with Ribera Care International.
Orthopedic and Traumatology Procedures
Orthopedic surgery is by far the most common reason Irish patients travel abroad for treatment. Many choose Spain to avoid long waiting lists and access advanced rehabilitation programs.
- Hip replacement surgery: for patients suffering from arthritis or severe hip pain, total or partial replacement offers faster recovery and improved mobility.
- Knee replacement surgery: one of the top-requested interventions, especially for degenerative joint disease and chronic pain.
- Arthroscopy and meniscus repair: minimally invasive techniques to treat cartilage or ligament injuries.
- Shoulder surgery: for rotator cuff tears or joint instability that limits movement.
- Spinal surgery and fusion: performed when conservative treatments fail to relieve chronic back pain or disc issues.
Ophthalmology and Eye Care
Eye procedures are another major reason Irish patients travel abroad for treatment. Cataract operations are particularly popular because of the long waiting times in Ireland’s public system.
- Cataract surgery: a quick, safe procedure to replace the cloudy lens and restore clear vision. Patients often choose Spain to access surgery within weeks instead of months.
- Refractive lens exchange and laser correction: available in selected hospitals for suitable candidates.
Cardiology and Vascular Surgery
Spain’s cardiac units attract patients who need timely intervention for heart or vascular disease. Hospitals within the Ribera network provide internationally accredited facilities and highly specialized cardiac teams.
- Angioplasty (stent placement): restores blood flow in blocked arteries through a minimally invasive procedure.
- CABG (Coronary Artery Bypass Grafting): surgical reconstruction of coronary blood flow in severe cases of coronary artery disease.
- Peripheral vascular procedures: for circulation disorders affecting the legs or carotid arteries.
General and Digestive Surgery
Many Irish patients also travel abroad for general or digestive surgery when waiting lists at home are long. These are routine procedures performed in accredited hospitals with high safety standards.
- Gallbladder removal (cholecystectomy) – laparoscopic technique with short recovery time.
- Hernia repair (inguinal or umbilical) – using modern mesh techniques to strengthen the abdominal wall.
- Varicose vein surgery – for chronic venous insufficiency or leg pain, sometimes combined with vascular evaluation.
Important note: Treatments such as organ transplants, clinical trials, long-term nursing care, and drug therapies not provided publicly in Ireland are not eligible under the Directive.
Always confirm with the HSE that your specific treatment is covered before making any travel or booking decisions.
How the process generally works
Below is a simplified overview of how patients from Ireland usually organise planned medical care abroad. The steps are for informational purposes only — always confirm the exact requirements with your national health authority before making any arrangements.
Step 1. Medical referral
Before travelling, you must be referred for treatment by your GP or specialist. The referral should describe your condition, the care required, and be signed by your doctor.
Step 2. Outpatient consultation
An outpatient consultation is required before any hospital admission or day-case procedure. For inpatient treatment, it must take place in person; for day-case procedures, it can often be done in person, by phone, or by video. Keep all medical documentation and receipts.
Step 3. Prior confirmation (optional but recommended)
Some public health systems allow you to request confirmation of eligibility before travelling. While not mandatory, it helps ensure that your treatment and expenses will meet reimbursement criteria.
Step 4. Choose a licensed hospital abroad
Select an accredited hospital or clinic within the EU/EEA that offers the treatment you need. Check that the service is equivalent to what would be publicly available in your home country.
Step 5. Receive treatment and pay the provider
You’ll pay the full cost of your care directly to the hospital or clinic. Be sure to request detailed invoices and proof of payment, as these are essential for any reimbursement process.
Step 6. Submit your documentation
After returning home, submit your referral letter, consultation report, invoices, and payment proof to your national health authority to request reimbursement. If your documents are in another language, certified translations may be required.
Why many Irish patients choose Spain
Spain offers an excellent combination of advanced medical technology, internationally trained specialists, and significantly shorter waiting times compared to Ireland or the UK.
Many Irish patients find that arranging treatment in Spain is straightforward, as hospitals with international departments provide support with logistics, documentation, and communication in English. Spain is often chosen because of:
- Fast access to surgery: appointments and procedures can usually be scheduled within weeks.
- Affordable care: prices are often lower than in northern Europe.
- Modern hospitals: such as Ribera IMSKE Valencia, equipped with state-of-the-art facilities.
- Postoperative rehabilitation: warm climate and dedicated physical therapy programs.
- English-speaking assistance: our international department supports you from arrival to recovery.
The EU Cross Border Directive allows Irish residents to receive timely medical care in Spain and apply to the HSE for repayment. While the process requires proper documentation, it offers patients a safe, regulated route to access surgeries sooner, especially for orthopedics, cardiology, and ophthalmology.
Ribera Care International helps Irish patients through each step: selecting hospitals, coordinating appointments, and ensuring all documentation aligns with HSE requirements.
If you’re considering treatment in Spain, Contact our Ribera Care International Patient Team.
For reference, this information is based on official guidance from the HSE. You can review the official details here: HSE – Types of Healthcare Available. Patients are advised to confirm the most up-to-date eligibility and coverage directly with the HSE before making any decisions.
Frequently Asked Questions about EU Cross Border Directive
Can I use the CBD for treatment in the UK?
No. According to the HSE, the Cross Border Directive no longer applies to the UK since 31 December 2020.
Are travel and accommodation covered?
No. Only medical costs are eligible for repayment. Patients must pay for flights, hotels, and related travel expenses themselves.
How do I start planning hip or knee surgery in Spain with Ribera Care International?
Start by obtaining your GP referral and confirming your eligibility with the HSE. Once you have your documents, contact our team to coordinate your consultation and surgery: https://riberacareinternational.com/contact-us/
How much will I be reimbursed?
You can only receive repayment up to the cost of the equivalent treatment in the Irish public health system. The HSE calculates the final amount after reviewing your full application.
