Since 1973 Ireland has operated a bilateral healthcare reimbursement agreement with the United Kingdom in respect of health services provided under EU Regulations. This agreement covers such persons as temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and the dependant families of persons employed in the other country.
Under the terms of the agreement net liability between the two countries is calculated on a lump sum basis. The amount payable is the net difference between the estimated costs to the two countries for providing healthcare to entitled persons. Payments are made in advance and are subject to final settlement once all necessary statistical and financial information for the particular year is complete. Total payments in any one year can relate to both final settlements in respect of previous years' liabilities and advance payments in respect of the current year. A total of €172 million has been paid by the United Kingdom in 2014.
By far the largest part of the payments made on an annual basis under the agreement relates to the provision of healthcare to pensioners of one country residing in the other country. The estimated number of pensioners for whom each country is liable was based on a sample survey undertaken by both administrations every three years, the most recent of which was completed in 2008.
Both administrations have since agreed, in principle, to work towards the introduction of a system of pensioner registration. This will form the basis for calculating reimbursement costs in the future. It was accepted that such a process would take some years to introduce. Consequently, both administrations agreed to interim arrangements for determining pensioner liability based on previous survey results trends. Discussions between both administrations on introducing such a system of pensioner registration are ongoing.
