Yes. The Cross Border Directive is a legal EU entitlement, not a discretionary scheme. The HSE is legally required to reimburse the cost of your surgery up to the amount it would cost in the Irish public system. The HSE’s own published price lists show that hip replacement surgery costs approximately €12,679 to €47,453 as an inpatient procedure in Ireland. The vast majority of our patients receive a full reimbursement of their surgery costs.

Reimbursement typically arrives within 6 to 8 weeks of submitting your completed application. We prepare and submit this application for you, and we have an outstanding track record of successful claims. We will always give you a clear cost breakdown in advance and tell you if there is any expected shortfall.

No. You do not need to already be on a public waiting list. You simply need to be entitled to public healthcare in Ireland (i.e. be ordinarily resident in Ireland and eligible as a public patient). Your GP needs to confirm in a referral letter that the treatment is medically necessary. This is the standard referral any GP writes when referring a patient to a consultant — not a complex or unusual document.

However, if you are already on a public waiting list, that actually makes your claim even more straightforward. The HSE Contact Point for Cross Border Healthcare is at St Canice’s Hospital, Kilkenny, and our team has extensive experience working with them.

Our surgeons are highly experienced specialists — complications are rare. However, we want to be completely transparent: like all surgery, hip and knee replacement carries a small risk of complications. These are no higher for surgery abroad than for surgery in Ireland.

If a complication occurs while you are in Amsterdam, you are in our hospital and under the direct care of your surgeon — the ideal situation. If something happens after you return to Ireland, your surgeon remains contactable and your GP can manage any post-operative issues. Under the Cross Border Directive, you remain entitled to aftercare in Ireland through the HSE. We provide your GP with full discharge documentation.

Yes — provided you are fit for discharge and your surgeon has approved the journey. Dublin to Amsterdam is under 2 hours, which is one of the shortest international flights available. Most of our patients fly home 4 to 5 days after surgery, following recovery at the Kim Zorghotel. You will be prescribed blood-thinning medication to take during recovery (standard post-operative care), and your surgeon will advise you on any precautions for the flight.

Hundreds of our patients have made this journey successfully. We schedule your return flight at a time that your surgeon is happy with — we never rush your discharge.

No. The Cross Border Directive is specifically designed for public patients — people without private health insurance. If you have a medical card, or if you are entitled to public healthcare as a public patient, you qualify. Private patients in Ireland can also access the CBD by reverting to their public patient status.

This is one of the most important and least-known facts about the CBD: it is a right for public patients, not a perk for the privately insured.

The CBD is a reimbursement scheme — you pay the hospital first and are refunded by the HSE afterwards. The most popular solution for Irish patients is a short-term loan from their local Credit Union. Credit Unions across Ireland are very familiar with the Cross Border Directive and regularly provide loans for this exact purpose — often within days of application. The HSE refund is then used to repay the loan.

When you call us, Sarah can advise you on how other patients have handled the financing, and point you to the relevant Credit Union resources. We will always give you a clear cost estimate before you make any commitment.

Both Spain and the Netherlands are excellent EU healthcare destinations for Irish patients under the CBD. We obviously believe Amsterdam and DHKC represent the best option for hip and knee replacement specifically, for these reasons:

• Flight time: Dublin to Amsterdam Schiphol is under 2 hours — shorter and less tiring than most Spanish routes
• Specialisation: DHKC is a dedicated hip and knee clinic. We do nothing else. This level of specialisation leads to better outcomes.
• Anterior approach: We offer the minimally invasive anterior hip replacement approach, which is not universally available in Spain and is highly sought after by patients
• The Kim Zorghotel: Our medically supervised recovery hotel is unique — nursing care and physiotherapy in a beautiful setting, included as part of your package
• Direct surgeon contact: Our surgeon contacts patients personally before and after surgery — a standard we are proud of

Our coordination service — including the work of Sarah Hyde in Ireland and Helen Faulkner in Amsterdam — is included as part of your treatment package. There is no separate fee for our patient liaison service.

You pay the hospital for your surgery and recovery hotel stay. The vast majority of this is reimbursed by the HSE. You pay for your own flights (typically €100–300 return) and any meals during travel. These costs are not covered by the HSE, but are a small fraction of the total.