Hip and Knee Replacement Abroad from Ireland: Poland and the HSE Cross-Border Directive (2026)

The Cross-Border Directive is an EU scheme for planned healthcare in another EU or EEA country. In Ireland the HSE runs it. The rules that matter for a hip or knee replacement:

1. You must be eligible for the same treatment in the Irish public system and live in Ireland (or intend to for at least a year). Private health insurance does not exclude you, but the referral must come from a GP or a consultant you saw as a public patient.
2. You need a referral letter, or a letter confirming you are on a public waiting list in Ireland for the treatment. The referral can be to a hospital abroad, and it must be dated before your consultation there.
3. You need an outpatient consultation before surgery. For an inpatient operation such as a joint replacement it must be in person: with your treating surgeon abroad, or with a consultant in Ireland who sees you as a public patient.
4. You pay the hospital abroad directly, then apply to the HSE with an itemised invoice and proof that you paid the hospital yourself.
5. The HSE repays you the lower of the price you paid and the Irish public price for the same care. It aims to pay within 30 working days of receiving all documents, but says processing currently takes longer.

The full step-by-step, with the documents each step needs, is in the Cross-Border Directive guide.

HSE prices are the inpatient prices in the ABF 2026 price list, in force from 1 September 2026. The HSE confirms the DRG code and the exact amount only after your treatment, and it can re-check the code with the Healthcare Pricing Office. Prior notification, which is optional, gives you an indication in advance.

What you pay yourself: flights, accommodation outside the hospital, and anything the hospital charges that is not treatment, such as a private room. These are not repaid. See HSE repayment amounts for every orthopaedic operation.

At the end of September 2026, according to the National Treatment Purchase Fund:

Many patients wait twice: first for an appointment with an orthopaedic consultant, then for the operation. Under the Cross-Border Directive a GP referral to a hospital abroad is enough, so the consultation abroad can replace the wait for the first Irish appointment. See the orthopaedic waiting list in Ireland.

Our partner hospital is in Jelenia Góra, south-west Poland, roughly 100–115 km, about an hour and a half by road, from Wrocław airport. Ryanair flies direct to Wrocław from Dublin (about 2 hours 45 minutes, two to three times a week in winter 2026/27) and from Shannon (about 3 hours). Check the current schedule before you plan dates. Your coordinator arranges the transfer from the airport to the hospital.

When you are fit to fly home is your surgeon's decision, made before you leave. Blood-clot prevention starts straight after surgery and you fly home with your medical records in English for your GP. Follow-up care can continue in Ireland: a GP can refer you for any follow-up in the public system.

• People who live in Northern Ireland: they are covered by the NHS, which no longer has a cross-border refund route after Brexit.
• People whose income or pension comes from the UK or Switzerland, or from another EU country: they may have to apply elsewhere or may not be eligible. The HSE asks them to contact it first.
• Anyone whose treatment is not available in the Irish public system.

If you are unsure, contact the HSE Cross-Border Directive office before you book (crossborderdirective@hse.ie, or HSE Live on 1800 700 700).

OrthoVoyage is a medical travel concierge, not a hospital, and does not give medical advice. HSE rules and prices can change; the HSE decides every claim.