Surgery in our new Spanish hospital is just some paperwork away! 


Since the Cross Border Directive made the news in Ireland a couple of weeks back, here is Surgery now, we are replying to hundreds of emails asking a version of the same question? 


Can I really get health care abroad through the Cross Border Directive?


The simple answer is YES! Here’s how it works for Surgery in Spain.


In 2011 the European Parliament in Brussels introduced the EU Directive on cross-border healthcare. This is far from “the brand new health care abroad scheme” that Joe Duffy was speaking about last week on RTE radio! 


The plan was and is to allow EU citizens to seek treatment in EU states apart from their own country. In Ireland, we implemented the idea by law SI 203/2014.


The term “Cross-Border Directive” is now synonymous with patients travelling to Spain to have treatments that they could get in Ireland. The problem for patients is the long HSE waiting list.

The Cross-Border Directive, as discussed, aims to ascertain certain rules for facilitating access to safe and prime quality cross-border healthcare within the European Economic Community. The main area clients are travelling to is Spain.

Surgery Now is the leading provider of the logistics associated with travelling to Spain for treatment. 

More about the cross-border directive. (CBD)

The Cross-Border Directive, according to the HSE website, means a European resident has the proper access to medical treatment in any Euro country. They must be treated on the identical basis as they’d in their home state, in our case, Ireland. Provided certain criteria are met by the Spanish hospital, Irish residents are entitled to request healthcare treatment in another European country, i.e. Spain. The care must be as good or better than the care in Ireland or the hospital does not make the grade.  The patient will receive reimbursement of the price of the qualifying treatment from their home healthcare system, i.e. the HSE.

Refunds are “up to” 100% and we tell all patients in advance, from our experience, if there will be any additional charges for say, prescriptions, consultations etc. 

The Cross-Border Directive covers planned healthcare, surgery, cataracts, knee and hip replacements etc. It will also cover emergency treatment in Spain which is typically covered through the insurance Card or EHIC system. 

Paperwork is simple, but….. not easy. Patients can do it themselves through the HSE website. Surgery Now do so many of the procedures in Spain that we know how to get them done. We think it is simpler and easier for our clients to ask our team to take care of this bureaucracy. We do it in our Dublin and Alicante offices for you, allowing our patients to spend more time getting better. 

Making a mistake on the application can cost our patients time in getting their refund. You are all aware of the red tape in the Irish medical system so getting the problem off the table is a big bonus for our clients. 

The application is also important for patients who need finance. We work with the Credit Unions of Ireland plus many other institutions who all insist on making sure the HSE is fully onboard with their clients, our patients. 


One of our top quality International private hospitals in Spain.


Some questions answered about the Cross Border Directive in Spain; 


What treatments are available in Spain under the scheme?

Basically, any service provided by the public health services in Ireland can be availed of under the Cross Border Directive (CBD). We deal with knees, shoulders, cataracts etc on a daily basis. Other treatments include; 

acute/psychiatric hospital services.

weight loss surgery (bariatric, for which the delay in Ireland is currently more than 4 years) 

ophthalmic (eye care)

dental/orthodontics services 

speech & language services

mental health care. 

occupational therapy services 

psychology services

physiotherapy services

disability services

methadone programme

and much more.


Are there restrictions for Irish people getting care in Spain?

The CBD scheme is not applicable to persons seeking:

services which are not provided for within the legislation of the Irish state

organ donation/transplant

long term/ residential care


If I am on a medical waiting list in Ireland can I apply?



Who is eligible for the Cross Border Directive?

If you are entitled to access services as a public patient in Ireland you are eligible. Generally, anyone who is ordinarily resident in Ireland is a candidate. If done correctly, approval can be done in days. 

Private patients in Ireland may not access funding under the CBD or the Treatment Abroad Scheme.  Private patients may however revert to public patient pathways in order to avail of their entitlements under the CBD in Spain. Any medical service provided by the HSE through the use of public funding to public patients can be described as public healthcare. Therefore it is ideal for the purposes of the Cross Border Directive in Spain. 


My wife and I have private health insurance in Ireland. Does this preclude me from applying for this scheme?

No.  Patients who have private health insurance can decide to simply not use it. Instead, they decide to be looked upon as public patients here in Ireland.  This status as a public patient entitles you to services in Alicante under the terms of the CBD. 


Can I access the information online?

Yes, on the HSE website.

Here you can learn the exact terms and conditions of the Cross Border Directive and how it works in Spain. In reality, we find some of the information a little confusing. It is not as complicated as some people think, it just feels like hard work. Our administration staff is delighted to help you with any aspect you are having issues with. 


If I decide not to use Surgery Now in Spain, who do I speak to? 

We cannot see any reason why not to use our free service, (currently free, as of July 2022) but in the case you want to do it yourself, you can always contact:

National Contact Point, Cross-Border Healthcare Directive Department, HSE Cross Border Directive, St Canice’s Hospital, Dublin Road, Kilkenny Tel: 056 778 4546 Email: [email protected]


If you prefer for us to take care of the paperwork, flights, consultations, finance, airport transfers, support in the hospitals etc why not call Liam/Noel or Elain for a 15-minute chat? 

Contact us today; 

[email protected]