EU member states have landed Ireland with a €34 million bill for the cost of providing healthcare for Irish people abroad.
The money, which includes an €11 million claim from Spain, is due under EU regulations governing the provision of healthcare in one member state to people who are insured in another.
The UK has lodged a claim for €8.5 million, though this is only for the cost of scheduled treatment provided to Irish people in Britain. France is seeking €6.7 million, Germany €2.3 million and Poland €1.3 million.
Under the regulations, a person insured by the healthcare system of one member state is entitled to receive the same services in another member state, at the cost of the country where the person in insured.
Although the right is not determined by citizenship, most of those in respect of whom claims are being made by other EU member states are Irish holidaymakers or retirees living abroad.
For its part, Ireland has lodged claims with other EU member states under the same directive amounting to almost €6 million.
The Irish claims range in size from €1.1 million sought from Spain to a bill for just €41 for Liechtenstein.
Bilateral arrangement
A separate bilateral arrangement exists between Ireland the UK to cover the reallocation of healthcare costs between the two countries.
This arrangement covers temporary visitors between the two countries, pensioners of one country living in the other, and the dependant families of people employed in other country. An estimated 130,000 UK pensioners live in Ireland.
Last year, the UK paid Ireland €277 million arising from this arrangement. The money is paid in advance, based on an estimate of the number of people in each category who are eligible for reimbursement.
Separate from the EU directive and the bilateral arrangement with the UK, an EU cross-border healthcare directive allows Irish citizens obtain treatment in other member states.
This directive cost the HSE €2.2 million last year, up from €500,000 the year before.
Fine Gael MEP Brian Hayes has expressed concern about the possible impact of Brexit on patients' rights, given that 40 per cent of Irish take-up under the cross-border scheme was in Northern Ireland.
