PDFREMA & PMAS

PDFREMA & PMAS

Who are PMAS ?

The PDFORRA Medical Assistance Scheme (PMAS) was established in 2017 and began assisting serving members access suitable medical care for injuries received in and out of active service under the terms of both the EU Cross Border Healthcare Directive (CBD) and the Northern Ireland Planned Healthcare Scheme (NIPHS) in July 2018. In May 2024 PMAS announced an extension of the scheme that now allows discharged members (who were members of PMAS whilst in service) to rejoin or remain in the scheme on discharge.

Cross Border Directive (CBD)

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. Treatment must be paid directly by the member and reimbursement is then applied for to the HSE.

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 Northern Ireland Planned Healthcare Scheme (NIPHS)

The Northern Ireland Planned Healthcare Scheme (NIPHS) allows you to claim back some of the cost of certain healthcare in Northern Ireland. You can only use the NIPHS to access private healthcare in Northern Ireland. You cannot use it for public healthcare. You must pay for any healthcare that you get in Northern Ireland.

Patients can apply to the HSE for repayment of some of the costs of the healthcare under the NIPHS. The NIPHS is similar to the Cross Border Directive (CBD). To get healthcare in Northern Ireland and claim a repayment under the NIPHS you must:

be ordinarily resident in Ireland – living in Ireland for at least 1 year
be entitled to public healthcare in Ireland
travel to Northern Ireland for your healthcare
have a referral for healthcare from a GP or public hospital consultant in Ireland
provide a copy of a letter of referral or a letter from a hospital to say you’re on a public waiting list in Ireland
apply for repayment towards the cost of your healthcare in Northern Ireland after you have paid for it

Where is treatment carried out ?

The vast majority of treatments are carried out in Kingsbridge Private Hospitals in either Ballykelly, County Derry or in Lisburn Road in Belfast under the terms of the NIPHS. On some occasions members also undergo treatment in mainland Europe under the terms of the CBD.

How does PMAS assist their members ?

PMAS connect members with private hospitals for treatment under the terms of both the CBD and the NIPHS. PMAS has negotiated reduced prices for members consultations and surgeries and submit applications to the HSE for both prior notification (pre-surgery) and reimbursement (post-surgery). ANSAC Credit Union provide the necessary finance for members surgeries and PMAS provide a guarantee for the loans. After the HSE reimburse members for their treatment PMAS repay the shortfall (the difference between the cost of treatment and the HSE reimbursement rate) and the associated loan interest.

PDFREMA members who were members of PMAS on discharge can rejoin PMAS automatically. To do so PDFREMA members should contact enquiries@pmas.ie for further information.

In the Short-term how will PMAS assist PDFREMA members who were not members of PMAS

Whenever PDFREMA members need access to cross border healthcare it is expected that PMAS will provide the following assistance in the short-term:

PMAS will provide information and support regarding all aspects of both the EU Cross Border Healthcare Directive (CBD) and the Northern Ireland Planned Healthcare Scheme (NIPHS) to ensure PDFREMA members comply with the patient pathway
PMAS will provide access to PMAS reduced consultation and surgery rates as kindly provided by Kingsbridge Private Hospital in Belfast and Ballykelly
PMAS will provide a liaison service between the patient, hospital and the HSE
PMAS will assist in the applications to the HSE for prior notification (pre-surgery)
PMAS will assist in the applications to the HSE for reimbursement (post-surgery)
PMAS will assist in the submission of appeals to the HSE as necessary

It should be noted that in the short term PDFREMA members (who were not members of PMAS on discharge) will be required to secure their own finance for their treatment. The support provided by PMAS ensures that they comply with HSE guidelines and that they realise as small a shortfall as possible (the difference between the cost of treatment and the HSE reimbursement rate). Also, in the short term PDFREMA will explore securing finance to minimize members shortfalls. It should also be noted that certain surgical procedures may cause significant shortfalls.

In the Long-term how will PMAS assist PDFREMA members who were not members of PMAS

PDFREMA intends to raise sufficient revenue to allow members (who were not members of PMAS whilst in service) to avail of full membership. Whenever PDFREMA has secured sufficient finance it is expected that members will be given the opportunity to join PMAS as full members.

Currently the subscription rates for discharged PMAS members are:

3 months membership: €20
6 months membership: €39
12 months membership: €75

Further information on all aspects of the scheme can be found on the PMAS website www.pdforramas.ie

R.E.M.A.

Established to represent PDF Enlisted
Personnel on Pensions & Related Matters.

PMAS

Supporting Injured PDForra Members
Offering our members the best in Private
Health Care.

PDFORRA

Working on behalf of all
all our members.

DEFENCE FORCES

We are proud to represent our
retired enlisted members.

ANSAC

Working with serving
& retired Enlisted Personnel.