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Frequently Asked Questions

WHAT IS THE CROSS BORDER DIRECTIVE AND HOW DOES IT WORK?

The Cross Border Directive (CBD) allows for patients ordinarily resident in Ireland who require and are entitled to public healthcare services to be referred to another EU/EEA* member state for that care and be reimbursed in accordance with the legislation. It will be a matter for the patient and his/her referring doctor to identify the clinician abroad and satisfy him/herself in relation to the qualifications, quality and safety of the services being availed of in the other jurisdiction. Funding will only be reimbursed for healthcare that is publicly funded and available in Ireland and which is not contrary to Irish legislation. Reimbursement will be made in line with published reimbursement rates available from the National Contact Point (NCP). Reimbursement will only be made to the patient or his or her parents/guardian in the case of a child. A private outpatient appointment in the Republic of Ireland may not be used under any circumstances to exercise rights for the purposes of reimbursement under the provisions of the Cross Border Healthcare Directive. The attendance of a private appointment in Ireland deems the patient a private patient and not a public patient for the purpose of provisions the Cross Border Directive.
The Northern Ireland Planned Healthcare Scheme (NIPHS) is similar to the CBD and you can use it to get healthcare in Northern Ireland.
HOW DOES THE PDFORRA MEDICAL ASSISTANCE SCHEME (PMAS) WORK?

The PDFORRA Medical Assistance Scheme (PMAS) will facilitate members, who subscribe to the Scheme, to receive treatment under the terms of the Northern Ireland Planned Healthcare Scheme (NIPHS). PMAS will assist authorised members, who have been suitably referred, to receive a consultation in Kingsbridge Private Hospitals in Belfast or Ballykelly, County Derry. If further treatment is required PMAS will secure finance for the member with ANSAC Credit Union. Once HSE permission is received the member will attend Kingsbridge to receive treatment and aftercare several weeks later. PMAS will assist members in the applications for both prior notification and reimbursement process to the HSE.
HOW DO I JOIN PMAS?

To join PMAS, PDFORRA members must apply to join the scheme and subscribe €1.50 per week. The application form to join PMAS is available on the PMAS website www.pdforramas.ie
Members can also request an application form by emailing PMAS at enquiries@pmas.ie
WHAT TREATMENTS ARE AVAILABLE UNDER THE SCHEME?

Any service which is provided by the public health services in Ireland can be availed of under the terms of the NIPHS. PMAS has a limited budget and therefore have restricted the amount of finance available to members to a maximum of €20,000 (previously €15,000). This maximum amount will be reviewed on an ongoing basis.
HOW WILL FUNDING FOR TREATMENT UNDER THE TERMS OF THE CBD BE SECURED?

ANSAC Credit Union have agreed to provide finance for PMAS members to receive treatment under the terms of the NIPHS. ANSAC Credit Union will lend the PMAS member the appropriate amount for treatment and PMAS go guarantor for the loan. After reimbursement has been received from the HSE PMAS pay the excess between the cost of the treatment and the amount of reimbursement received. PMAS will also pay any accrued interest on the loan.
DO I NEED TO BE A MEMBER OF ANSAC CREDIT UNION TO JOIN PMAS?
ARE THERE ANY RESTRICTIONS?
WILL I NEED TO PAY THE SHORTFALL BETWEEN THE COST OF TREATMENT AND THE RATE OF REIMBURSEMENT RECEIVED FROM THE HSE?
WILL I NEED TO PAYTHE INTEREST THAT ACCRUES ON MY ANSAC CREDIT UNION LOAN?
WHERE WILL THE TREATMENT BE CARRIED OUT?

PMAS has secured the services of Kingsbridge Private Hospitals in Belfast and Ballykelly County Derry. Kingsbridge Private Hospital prides itself on delivering a five-star experience to each and every patient who crosses their door. On some occasions whenever Kingsbridge cannot provide suitable treatment, PMAS will help members access treatment with other suitable healthcare providers.
HOW DOES A MEMBER GET REFERRED FOR TREATMENT?

PMAS have been in contact with the Director of the Medical Corps to highlight the benefits of having members treated under the NIPHS. PMAS have been informed that all Medical Officers will be informed of this initiative and will refer members to Kingsbridge. Members can also get a referral letter from their GP.

DOES THE FACT THAT I HAVE PRIVATE HEALTH INSURANCE PRECLUDE ME FROM APPLYING FOR THIS SCHEME?
IF I AM ON A PUBLIC WAITING LIST CAN I APPLY?
WHERE CAN I GET FURTHER INFORMATION ON THE NORTHERN IRELAND PLANNED HEALTHCARE SCHEME (NIPHS)?
IF I KNOW I NEED TREATMENT CAN I SELF-REFER?

You may not self-refer. You must have a referral from a Medical Officer or GP to a consultant appropriate to the type of care you are seeking to access. PMAS have been informed that all Medical Officers will be informed of this initiative and will refer members to appropriate consultants in Kingsbridge.
Please note, under no circumstance will an outpatient appointment in a private capacity in Ireland be accepted for the purpose of accessing healthcare abroad under the NIPHS. Public referral pathways as applicable in Ireland must be adhered to.
It is of course understood and accepted that any private patient can opt to avail of public patient status but only by following public referral pathways: private status cannot be used as a means of circumventing waiting lists for the purposes of prioritised access.
Please note, under no circumstance will an outpatient appointment in a private capacity in Ireland be accepted for the purpose of accessing healthcare abroad under the Cross Border Directive. Public referral pathways as applicable in Ireland must be adhered to. Public consultant appointments can only be accepted.
HOW AND WHERE DO I APPLY FOR A REIMBURSEMENT?

Requests for reimbursement will be made through the NCP office. The have introduced a pro-forma invoice so that patients will have a document which guides them through the required information in order to claim reimbursement. PMAS will assist members with the reimbursement process.
CAN MY HUSBAND, WIFE OR PARTNER JOIN PMAS?

PMAS members can now add their husband, wife or partner to the scheme. To do so they must complete an application form and agree to pay an additional €1.50 weekly. This will increase their weekly subscription from €1.50 for individuals to €3.00 for a couple. PMAS members can add their husband, wife or partner subject to the qualifying criteria: They must be ordinarily resident in the Republic of Ireland, must be registered with a GP in the Republic of Ireland and must have a PPS number
CAN DISCHARGED PMAS MEMBERS ACCESS TREATMENT THROUGH PMAS?

Discharged PMAS members who have re-joined the scheme can now access the same treatment as serving members. Discharged members must satisfy the qualifying criteria: Have been ordinarily resident in the Republic of Ireland for the past 12 months, have been a member of PMAS on discharge, are currently registered with a GP in the Republic of Ireland and pay the appropriate subscriptions to PMAS

HOW CAN DISCHARGED PMAS MEMBERS SUBSCRIBE TO PMAS? There is no deduction at source facility from discharged members pensions. Discharged members must complete an application form and arrange payment to PMAS. Membership subscriptions are priced at €75 annually.

CAN DISCHARGED PMAS MEMBERS ADD THEIR HUSBAND/WIFE/PARTNER JOIN PMAS?

Discharged PMAS members can now add their husband, wife or partner to the scheme. To do so they must complete an application form and agree to pay an additional €75 annually. This will increase their annual subscription from €75 for individuals to €150 for a couple. Discharged PMAS members can add their husband, wife or partner subject to the qualifying criteria: They must be ordinarily resident in the Republic of Ireland, must be registered with a GP in the Republic of Ireland and must have a PPS number
IF MY CHILDREN OR PARENTS ACCESS TREATMENT WHAT SUPPORT WILL PMAS PROVIDE?

PMAS has assisted many family members access treatment under the terms of the NIPHS. PMAS family members can avail of the significant discounts that PMAS has negotiated with Kingsbridge Private Hospital. PMAS will also provide significant administrative support and a liaison type service between the family member, the HSE and the hospital as necessary. PMAS members can get further information by emailing enquiries@pmas.ie
HOW CAN I GET FURTHER INFORMATION?
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PMAS

Devlins Complex, Bonamaine, Bridgend,

Donegal, F93 EC5K

1800 200 250

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