Living there · 28 September 2026 · 6 min read
Surgery in Spain on the HSE, and recovering on the coast.
If you've been on an Irish waiting list for a hip or a knee, you may have heard of people having the operation in Spain and getting the HSE to pay towards it. It's true, and it runs through an EU scheme the HSE operates every day. We're not a medical service and we don't recommend surgeons or hospitals. What we can help with is the part the medical sites skip: where you'll recover, and what the weeks after look like on this coast.
How the scheme works
It's called the Cross Border Directive scheme. If you live in Ireland and you're entitled to public hospital care, you can have treatment in another EU country, in a public or a private hospital, and claim money back from the HSE afterwards. You need a referral from a GP or a consultant, and it has to be a public referral, even if you have private health insurance. Before inpatient or day-case treatment you also need an outpatient consultation, which can be with the surgeon abroad. There's no minimum time you have to have waited.
You can ask the HSE for prior notification before you go. It's voluntary, but it's the sensible way to find out where you stand before you've spent anything. The HSE sets out the steps on its Cross Border Directive page.
The money
You pay the hospital yourself and claim afterwards. The HSE repays whichever is lower: what you paid, or what the same treatment costs in the Irish public system, which it prices by procedure and reviews every year. If the Spanish hospital charges more than the Irish price, the difference is yours to cover. So are the flights, the accommodation, any translation and the recovery stay.
Before you commit, get a written quote from the hospital and ask the HSE what it would repay for that procedure. Then you know the gap, and it's a decision you can make with your eyes open.
Where you'll recover
A new knee or hip changes what a good flat looks like. You want the ground floor or a lift that works, no steps up to the front door, a walk-in shower, a bed you can get in and out of easily, and flat ground outside for the short walks you'll be told to take. Being near the hospital that did the operation matters more than a sea view, because you'll be going back for check-ups.
Book it as a short let and tell the owner exactly why you're coming, so they can be straight with you about stairs and access. Our town pages show the health centres and hospitals in each town and how you'd get to them, which is the first thing to check.
Aftercare, and getting home
Ask the hospital what physiotherapy you'll need here and what happens once you're home. Physiotherapy is one of the services the scheme covers, so it's worth asking the HSE whether any you have in Spain can be claimed too.
When you can fly, and whether you need anything for the flight, is for your surgeon to decide, and airlines have their own rules as well. Leave some slack in the return date and don't book it tight before the operation's done. Your EHIC is for care that can't wait while you're visiting and doesn't cover planned treatment, so it isn't the route for the operation itself.
A trial run, if you've been wondering
A few weeks here in recovery isn't a holiday, but it's the coast on an ordinary weekday, which tells you more than a week in August ever will. If you've been thinking about spending winters here or buying, the next reads are rent a year before you buy and our free Wintering in Spain guide.
If you're planning to move here
The scheme is for people who live in Ireland. Once you move over and your healthcare becomes Spanish, you're a patient in the Spanish system, and whether any route back to Irish care is left open to you is a question for the HSE before you move. How healthcare works at each stage is in healthcare in Spain for Irish owners.
Spending part of the year here?
Our free Wintering in Spain guide covers the tax days, pensions, healthcare, running costs and the car, checked against the official sources.