Hip and knee replacement in Ireland: HSE, NTPF, health insurance and tax relief

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Hip and knee replacement in Ireland: HSE, NTPF, health insurance and tax relief

General information only. Not medical, insurance or legal advice. Coverage rules and prices change, so confirm with your insurer or public health service (such as the NHS, HSE or Medicare) before booking, and ask your doctor whether a procedure is right for you.

Last checked: October 2026 · Protocol Archive Editorial · General information, not medical, insurance or legal advice

Public route (HSE)

Your GP refers you to a hospital orthopaedic service. If you have been on the waiting list for more than 3 months and are clinically suitable, the hospital or the NTPF may contact you with an offer of treatment, which you won’t pay for.

Treatment in Northern Ireland or the EU

The HSE says you can no longer use the Cross Border Directive for healthcare in the UK. For treatment with a private provider in Northern Ireland, you can use the Northern Ireland Planned Healthcare Scheme instead. You pay first and claim back up to what the treatment would cost in the Irish public system. The HSE publishes a guide to these amounts, but they change, so ask the HSE before you book.

Private health insurance

  • Irish Life Health’s 2024 orthopaedic schedule lists total hip and total knee replacement without pre-approval, but some plans add a fixed co-payment for certain orthopaedic procedures in private hospitals.
  • Waiting periods for pre-existing conditions can be up to 5 years, which Irish Life Health, Laya Healthcare and Vhi all currently apply.
  • Ask your insurer whether your hospital is covered in full and whether your consultant is participating.

Paying yourself: 20% tax relief

Consultant fees and hospital treatment generally qualify for tax relief at 20%. Claim within the 4 years after the year you paid, through Revenue’s myAccount (PAYE) or your self-assessment return. You can’t claim for amounts your insurer or the HSE refunded. Ask the hospital for a written quote.

If your insurer refuses

Complain to the insurer first, then to the Financial Services and Pensions Ombudsman, which is free. See how to appeal.

Frequently asked questions

Can I get my hip replaced in Northern Ireland and claim it back?

Possibly, through the Northern Ireland Planned Healthcare Scheme. You pay the hospital, then claim back up to the Irish public cost. Travel costs aren’t covered. Contact the HSE before you book.

Before and after surgery

NICE recommends therapeutic exercise, and weight management where appropriate, as core treatments for osteoarthritis. Its joint replacement guideline says people should get advice on exercise before surgery.

Your surgical team or a physiotherapist can tell you which exercises suit you before and after an operation.

Sources

  1. HSE: Who a hip replacement is for
  2. HSE: Options while on a waiting list
  3. National Treatment Purchase Fund: Patients and public FAQs
  4. HSE: Cross Border Directive, how to get it
  5. HSE: Northern Ireland Planned Healthcare Scheme, how much you can claim
  6. HSE: Cross Border Directive and Northern Ireland Planned Healthcare Scheme, most common procedures guide
  7. Irish Life Health: Schedule of benefits, orthopaedics (2024)
  8. Irish Life Health: Health Plan 01 table of cover (from 1 July 2026)
  9. Health Insurance Authority: Waiting periods
  10. Citizens Information: Tax relief on medical expenses
  11. Financial Services and Pensions Ombudsman: Make a complaint
  12. NICE guideline NG226: Osteoarthritis in over 16s, recommendations 1.2.2 and 1.6.1 to 1.6.3
  13. NICE guideline NG157: Joint replacement (primary): hip, knee and shoulder

Last checked October 2026. Found something out of date? Email hello@protocolarchive.com.

This page explains how coverage usually works, using public NHS, insurer, ombudsman and government sources listed above. It is general information, not medical, insurance, financial or legal advice, and it does not recommend any treatment, policy or provider. Rules differ by area and by policy and can change, so confirm with your GP, your insurer or the hospital before you decide. Protocol Archive is independent and is not affiliated with the NHS, the HSE or any insurer.