Applying for repayment on your health care abroad. 


One of the key elements of skipping the long waiting times back in Ireland is that through the CBD (Cross Border Directive) you can get a full refund. 

Clients of Surgery now can reclaim the cost of healthcare under the Cross Border Directive (CBD). The refund is up to the maximum amount of its cost in Ireland. Lets start with the negatives of skipping the long wait times in Ireland and coming to Spain now for your treatments; (there are very few of them) 

What do I not get a refund on? 

Through the CBD scheme, currently, you can not claim for the cost of any prescription drugs you may need after your healthcare. The cost of prescription medicine in Spain is generally much less expensive than it is in Ireland. Transport to and from the airport, hospital etc is not eligible for refunds. However, Surgery Now will collect all our clients and take them to their accommodation, to the various hospital and doctor consultations etc as part of our free service.

You cannot claim translation costs. Almost all of these expenses are covered by Surgery Now and our bilingual team.

Another expense is Travel. You won’t be paid for any travel costs, accommodation etc when you come to Spain. At Surgery Now our Free service is here to help. We can organise any type of stay our client’s request, within reason. 

  • Some of our patients just want to get in and out of the country within a few days. Depending on the treatments, this is fine with us.
  • Some Surgery now clients already own property in Spain or know someone who does. We’ll pick you up at your temporary home and take you to all treatment sessions. 
  • Many people bring a family member to be here with them pre and post-surgery. Some clients wish to extend their stay to avail of the sunny Spanish climate. We think this genuinely aids recovery: either way, we will arrange the best option for you.


You can claim all medical costs from the HSE.

We explain to our clients before they travel to Spain that they must pay for the healthcare themselves and then apply to claim it back.

If you are having healthcare that involves an overnight stay in a hospital, we advise all our clients to apply before they go abroad for pre-authorisation through the HSE.

Don’t worry, we take care of the paperwork for you. 

How much can you claim from the HSE? 

Simple, Clients can claim repayment for whichever is the lower amount:

  • the cost of your healthcare abroad. We tell you this amount in advance. 
  • what the healthcare would have cost in Ireland if you had chosen to have the procedure there. 

If the healthcare costs less in Spain than it would have in Ireland you can only claim for what you paid. It makes sense of course. 

Outpatient healthcare claims in Spain. 

The maximum you can be repaid for an outpatient consultation in a hospital abroad is €178.

This has changed since 1 March 2021, when the maximum was just €130.

Outpatient care, as most of our clients know, involves healthcare that doesn’t require an overnight hospital stay.


Day-case healthcare claims in Spain. 

Day-case care abroad involves healthcare that does not require an overnight stay in a hospital.

The HSE has a list of day-case healthcare costs in Ireland which we operate with. You can find it online or ask us here for a copy.   

We at Surgery Now use this document to find out the maximum amount you can reclaim. The updated document is for Irish people who have had their treatment in Spain on or after 1 August 2020.

If you had your treatment or procedure before 31 July 2020  we have an alternative document, again we are happy to share it with you. 

You can also use this document to find out the maximum amount you can reclaim.

Inpatient healthcare claims in Spain. 

Inpatient care in Spain, or anywhere for that matter, is healthcare that involves an overnight stay in a hospital.

Again, the HSE has a list of inpatient healthcare costs in Ireland. We use this document to find out the maximum amount you can reclaim, for people who have had their treatment on or after 1 August 2020.

The HSE will deduct €80 per night, to a maximum of €800, from the amount you can be repaid, if you’ve had inpatient care abroad. 

The €80 per night is not owed if either of the following applies:

  • You have an Irish medical card.
  • Over the past year, you have already paid €800 for overnight stays in hospitals abroad or in Ireland.

Repayment cost examples

Imagine a procedure, let’s say a hip replacement. The cost in Ireland of the surgery is €10,000, in this example, with an €80 per night hospital charge.

If the cost in Spain is €11,000 for example and you were in the hospital for 5 nights then you can claim for €9,600. (€10,000 less the inpatient charge of €400). 

Now imagine the cost in Spain was €5,000 and you were in the hospital for 5 nights. In this example, you can claim €5,000 as this is less than the cost in Ireland of €10,000 (minus €400).

How to apply for repayment under the Cross Border Directive. 

We take care of the paperwork on behalf of our clients. The process is complicated but simple for our staff due to our excellent working relationship with both the HSE and the private hospital sector in Spain. In the unlikely event you want to go it alone, you and your healthcare provider abroad should complete the Cross Border proForma invoice. A copy can be sent to you by us if you request it. 

Please remember, if you are not going to work with Surgery Now, to ask the consultant to fill in the pro forma invoice. This should be done before leaving the hospital. If you forget for any reason, please ask us to help at absolutely no cost to you. 

All repayments are made only to the patient or their parent or guardian if the patient is under 18. Many of our clients use the arrangement we have with the Credit unions in Ireland and a number of other financial institutions. 

The executor of the patient’s estate would apply for repayment if the patient is dead.


Misleading information around the CBD.

Clients are breaking the law if they enter any false or misleading information on the pro forma invoice. Please be careful and make sure to get it right. We can help, again for absolutely no charge. 

Thankfully, it has not happened with any of our patients, however, if you are paid money based on false or misleading information, as you’d expect, the HSE will reclaim the money from you.


How does Surgery now process the claim repayment? 

With our expertise, this is a simple operation for our team.

You must submit:

  • Your completed CBD pro forma invoice.
  • The hospital’s original invoice and receipt.
  • A referral letter from the GP in Ireland or public consultant who referred you.*
  • Proof of travel such as a plane ticket receipt, boarding pass etc so that we can prove you travelled abroad for your healthcare.

* Your referral letter must be signed by your GP or public consultant in Ireland. It can’t be signed by their nurse or secretary. It should be issued and dated before you had your initial appointment in Spain and addressed to the named doctor and hospital or clinic your GP or public consultant had referred you to. 

When you can expect repayment. 

As a general rule, usually, Surgery Now aims to repay patients within 30 working days of getting all the completed documents. Often it can be much quicker. 


Is there any downside to using Surgery now?

We cannot see any disadvantage to using the service of Surgery Now. We charge absolutely nothing for the service, we work with the best medical care professionals in Europe, all credit unions in Ireland, the best chains of hotels in Spain and we have a wonderful relationship with the HSE. We provide you with transfers to and from airports and hospitals and offer discounted accommodation. We visit the hospital with you and we are here at all times to make sure that your procedure in Spain goes smoothly. We can ensure you get your refund quickly and we make sure that all the paperwork is done exactly as the HSE hopes it will be. 

The time-saving difference between surgery in Spain and waiting on the list back in Ireland can be two years. 

The quality of the surgery is incredible, as is the aftercare you’ll receive here. Also, it is Spain, not some East European country. Spain is the most visited country in Europe. It is not some far off in the distant strange land. The people are friendly, it is safe and easy to get here. 

Our clients love the feeling of waking up to the sunshine post-surgery in one of the most beautiful places on earth. Yes, this speeds up your recovery. 

Many of our clients become our friends and stay in touch with us long after their pain has gone away. If you’d like to speak to any of our previous clients to get a feel for our service, we’ll be happy to give you a few names. Our clients promote us to any potential patients who are unsure. 

If you’d like to chat with our Irish staff please send us a message here and we’ll call you back.