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Frequently Asked Questions Temporary ROI Cross Border scheme

Frequently Asked Questions

Temporary ROI Cross Border Healthcare Reimbursement Scheme

Please note: this Scheme closed to new applicants at 5pm on Wednesday 21 September 2022.

  • 1. Who is eligible to apply for this scheme?
    • People who are ordinary resident in Northern Ireland and
    • People who have been diagnosed as having a clinical need for the treatment by a Northern Ireland clinician
    • People who are on a Health and Social Care Trust waiting list for treatment
  • 2. What procedures can I get reimbursed for?

    The scheme covers all aspects of health care except the following:

    • Long term care which provides assistance with routine tasks i.e. social care
    • Access to and allocation of organs (for transplantation)
    • Public vaccination programmes against infectious diseases
    • Services which are not commissioned by the Strategic Planning and Performance Group (SPPG)

    You must apply for authorisation from the SPPG for your treatment before you get it otherwise it will not be reimbursed.  At this point, it can be confirmed if your treatment is covered under the reimbursement scheme.

  • 3. Where can I get treatment and be reimbursed?

    Before you source your treatment, you must obtain prior authorisation from the SPPG so you can be reimbursed.

    You can get private treatment in the Republic of Ireland, either with a state or a private provider. You will be responsible for making your own arrangements for treatment, including sourcing the provider.

  • 4. How do I apply for this?

    You will need to fill in an application form, source your own healthcare provider for the treatment you want in the Republic of Ireland and ensure you get prior approval from the SPPG before proceeding with your treatment.

  • 5. Will I need to get prior approval before proceeding with my treatment?

    Yes, you will need to get prior approval form the SPPG before proceeding with your treatment, if you want to be reimbursed for your procedure.

  • 6. What happens if I do not get prior approval before my treatment?

    Your procedure will not be eligible for the scheme and you will not be reimbursed for your procedure.

  • 7. Will I be reimbursed in full for the cost of my treatment?

    Reimbursement under this scheme will only be up to the equivalent of the actual cost of the treatment in Northern Ireland or the HSC NI average cost (whichever is lower). It will not include travel or accommodation costs. Patients should arrange any post-operative care with his or her Northern Ireland treating Consultant or GP.