Your legal right to treatment abroad.
As an Irish public patient, you have the right to seek treatment at Clinic Agatas in Lithuania and claim reimbursement from the HSE. We help you through every step of the process.
Who can apply
The EU Cross-Border Healthcare Directive is available to Irish public patients who meet all of the following criteria. If you are unsure whether you qualify, contact us and we will assess your situation at no cost.
- You have been living in Ireland for at least 1 year
- You are eligible for the same treatment in the Irish public health system
- You have a referral from a GP or public consultant in Ireland
- You are on a public waiting list for spine surgery or pain management
- You pay for treatment yourself — insurance payments are not eligible
What is not covered
The CBD covers the cost of medical treatment only. The following are never reimbursable regardless of circumstances.
- Flights to and from Lithuania
- Hotel accommodation before or after surgery
- Transport between hotel, clinic and sanatorium
- Meals and daily living expenses while abroad
- Translation costs for documents not in English
- Fees paid to third-party medical tourism agencies
How much can you claim back?
HSE reimburses the lesser of two amounts: what you paid at Clinic Agatas, or the Irish public system rate for the same procedure. All rates are from the official HSE day case price list effective 1 July 2025.
HSE Day Case Reimbursement Rates
Important: Clinic Agatas is a licensed day surgery centre
All procedures at Clinic Agatas are classified as day case under Lithuanian healthcare regulations. HSE reimbursement is calculated at the Irish day case rate. We provide overnight medical supervision as standard post-operative care, but your formal discharge is same-day.
Can rehabilitation at Egle Rehabilitation center be reimbursed?
HSE assesses rehabilitation reimbursement individually, based on your procedure and clinical condition. Egle Sanatorium in Birstonas is a licensed medical rehabilitation centre that meets the requirements for CBD reimbursement consideration.
Before you travel, we strongly recommend submitting a prior notification that includes rehabilitation. HSE will confirm what is covered in your specific case and at what rate, before you commit to anything.
What prior notification tells you
- Whether your rehabilitation qualifies for reimbursement
- Which specific procedures at Egle Sanatorium are covered
- The indicative reimbursement amount for your rehabilitation
- Any conditions or limitations that apply to your case
Our recommendation
Include rehabilitation in your prior notification application before you travel. This is the only way to know in advance what HSE will cover in your individual case. We help you prepare and submit this application as part of our standard process.
Ask us about prior notificationAccommodation and meals at Egle Sanatorium are not reimbursable under the CBD regardless of prior notification outcome.
How the process works
Six steps from your first contact to receiving your HSE reimbursement.
Get a referral from your GP
Ask your GP for a referral letter confirming you are on a public waiting list in Ireland for spine surgery or pain management. The referral must be dated before your consultation at Clinic Agatas. This is a strict HSE requirement.
Submit a prior notification to HSE
Before you travel, we recommend submitting a prior notification to the HSE Cross-Border Directive office in Kilkenny. HSE responds within 6 weeks to confirm your eligibility and give an indication of your reimbursement amount. Our specialist helps you complete this step.
Online consultation with your surgeon
Send your MRI scans and have a remote consultation with your neurosurgeon. He confirms whether surgery is appropriate and outlines your treatment plan. This is not counted as your mandatory pre-operative consultation.
In-person consultation the day before surgery
You arrive in Kaunas and meet your neurosurgeon in person the day before your procedure. This in-person consultation is a mandatory HSE requirement. Surgery is never performed on the day of arrival.
Surgery at Clinic Agatas
Your procedure is performed at our licensed day surgery centre. You pay the clinic directly. Keep your invoice and receipt — these are required documents for your HSE claim.
Apply for reimbursement
After treatment, we provide your Discharge Summary and Operative Report with the correct DRG code. You submit the completed HSE Healthcare Costs Application Form along with your referral letter, invoice and proof of payment. HSE processes your claim within 30 working days.
Documents you will need
Your HSE application will be rejected if any document is missing or incorrectly completed. We provide all clinical documentation from Clinic Agatas. You are responsible for the referral letter from your GP and proof of payment.
GP referral letter
Must confirm you are on a public waiting list. Must be dated before your consultation at Clinic Agatas. Must include your name, address, date of birth, diagnosis and GP signature.
HSE Healthcare Costs Application Form
Available from hse.ie. Section 4 must be completed by your neurosurgeon at Clinic Agatas. Must be in English.
Download form →Invoice and receipt from Clinic Agatas
Must include your name and address, clinic name and address, procedure name, date of treatment and amount paid with full breakdown.
Proof you paid directly
Bank statement or card receipt showing payment to Clinic Agatas. The payee name and amount must match your invoice exactly.
Prior notification confirmation (recommended)
Not mandatory but strongly recommended. Confirms your eligibility and indicative reimbursement amount before you travel.
Download form →Why claims get rejected
These are the most common reasons HSE rejects or reduces reimbursement claims. We structure your treatment at Clinic Agatas to avoid every one of them.
HSE processes claims within 30 working days of receiving all completed documents. Payments are made directly to the patient.
Not sure if you qualify?
Contact us and we will assess your eligibility at no cost. If you qualify, our specialist will guide you through the prior notification process before you travel.
Services
Contact Details
Klinika Agatas Ltd.
Irish Coordinator Mindaugas (Minde)
- +353 871 753 061
- Paryžiaus Komunos g. 2A, Klaipėda, Lithuania
- Baltic Clinic Ltd.
2026 Clinic Agatas. All rights reserved.