Health Insurance Cross Border Healthcare Directive & Insurance

P

Poseidon

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Hi,

My family is currently insured to a high level and I have been throughout my life thus far. However, the tax levy on such policies and poor level of care afforded private patients here is making me rethink.

My understanding is that the public system differs little from the private care system for urgent ailments - e.g. cancer, stroke & CV disease. Private care only seems to help to skip waiting lists for non-life-threatening illnesses (e.g. hip replacement).

Why shouldn't I cancel my cover here & instead use private hospitals in Belfast, paid for by the HSE via the EU Cross Border Directive for non-life-threatening issues? BTW: I'm ignoring Brexit in this discussion for now.
 
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Sounds fine, in theory! However, the CBD scheme will only approve your attendance 'abroad' if you show a considerable waiting list. Also, the fees that will be refunded may fall well short of what you actually incur.

We recently processed a claim for day surgery, no travel or accommodation costs and received about 50% back.
 
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Many thanks for the replies. It's particularly interesting to hear from someone who has used the CBD. However, I note that:
  • From the HSE's FAQ on the CBD: "There is no requirement to be on a waiting list in order to access healthcare under the provisions of the CBD. You must have followed public patient pathways i.e. in general this means you must have a referral letter for the treatment you are seeking to operate abroad." In other words your GP can directly refer you to a consultant in Belfast.
  • Diagnostics / Scans are fully covered under the CBD.
  • Under the CBD, reimbursement is up to the level of the cost of the procedure carried out here, less any public patient charges that would have been incurred should the treatment have been carried out here. This is fully transparent, as the fees are published on the HSE's procedures list (e.g. 10k euros for a hip replacement): hse.ie/eng/services/list/1/schemes/cbd/Ready%20Reckoner.pdf . Since the HSE's procedure costs are some of the highest in Europe, reimbursement should cover 90%+ of the cost of a procedure carried out in the UK, unless it is low cost (such as day surgery). Of course, the minimal cost of travel to, and accommodation in, Belfast will not be covered.
One disadvantage of my approach is that the patient must pay the cost of the procedure up front, necessitating considerable savings or access to a short-term loan facility.
 
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