The Directive on Patients’ Rights in Cross Border Healthcare provides rules for the reimbursement to patients’ of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State (Member State of Affiliation) and supplements the rights that patients already have at EU level through the legislation on the coordination of social security schemes (regulation 883/04).
The Directive seeks to ensure a clear and transparent framework for the provision of cross-border healthcare within the EU, for those occasions where the care patients seek is provided in another Member State rather than in their home country. However, it should be emphasised that the vast majority of EU patients receive healthcare in their own country and prefer to do so. The Department of Health is continuing to work on the necessary statutory provisions to fully implement the Directive and will have them in place as soon as possible.
Nevertheless, there are arrangements in place in respect of the key provision of the Directive in relation to a national contact point (NCP), which has been set up within the HSE and will administer the information and reimbursement aspects of the Directive. The principal function of the NCP is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost, the procedures for accessing and determining those entitlements. The NCP also has a responsibility to ensure that all enquirers are informed of the rights, if any, that they may have through the legislation on the coordination of social security schemes (regulation 883/04) and which may be more beneficial to them. The NCP will be able to inform patients what the cost of their treatments would be in Ireland to allow them make a comparison with the costs they are being quoted for comparable treatment in another Member State.
The Directive allows Irish residents to avail of healthcare in other EU member states that they would be entitled to within the public health system in Ireland, and which is not contrary to Irish legislation. The costs must be born by the individual and he/she then seeks reimbursement for the cost of the healthcare upon return to Ireland. Costs will only be reimbursed up to the level that would have been arisen if the healthcare had been provided in Ireland or the actual cost of the healthcare in the other member state, whichever is the lesser. Where the medical treatment being sought is not available in Ireland, patients may, as at present, apply for the Treatment Abroad Scheme operated by the HSE under EU Regulation 883/04.