Overseas Medical Treatment Tax Relief Ireland 2025: Two Scenarios Explained

Revenue-compliant guidance — Based on Revenue Tax and Duty Manual Part 15-01-12, s.9 (s.469 TCA 1997). Updated for 2025.

Whether travel and accommodation qualify for tax relief on overseas medical treatment depends entirely on why you went abroad. Under Revenue’s s.9 guidance: if the treatment was only obtainable outside Ireland, travel and accommodation qualify alongside treatment costs. If the treatment was available in Ireland but you chose to go abroad, only the treatment costs qualify — flights and hotels do not. This distinction is critical and commonly misunderstood.

What This Page Covers

• The two-scenario framework under s.9 of Revenue’s Part 15-01-12
• Scenario 1: treatment only obtainable abroad — what qualifies and what evidence is needed
• Scenario 2: treatment available in Ireland, chosen abroad — only treatment costs qualify
• Dental tourism, elective surgery abroad, and second opinions
• Converting foreign currency costs: exchange rate and documentation
• Documenting overseas treatment for a Revenue claim

Key Facts at a Glance

• ✓Treatment only obtainable outside Ireland: treatment costs + travel + accommodation all qualify.
• ✓Treatment available in Ireland, chosen abroad: treatment costs qualify; travel and accommodation do not.
• ✓An Irish consultant letter confirming unavailability in Ireland is essential for Scenario 1 travel claims.
• ✓Convert foreign currency costs to euro using the exchange rate on the date of payment.
• ✓Claim in myAccount Health Expenses; backdate up to four years.

The two-scenario framework under s.9

Section 9 of Revenue’s Tax and Duty Manual Part 15-01-12 sets out how overseas medical treatment is treated for Irish income tax health expense relief. The framework is built around two distinct scenarios, and understanding which scenario applies to your situation is the single most important step in determining what qualifies for relief.

The fundamental question is: was the treatment you received abroad available in Ireland at the time you went abroad? The answer to this question determines whether travel and accommodation qualify alongside the treatment costs, or whether only the treatment costs themselves qualify.

Scenario 1: treatment only obtainable outside Ireland

Where the treatment a patient required was genuinely not available in the Irish healthcare system — either public or private — at the time the treatment was sought, both the treatment costs and the associated travel and accommodation qualify as health expenses.

What “only obtainable outside Ireland” means in practice

Treatment is only obtainable outside Ireland where no Irish hospital, clinic, or medical practitioner — whether public or private — offers the specific treatment required. This is a high bar. It applies in situations such as:

• Highly specialised surgical procedures not performed in Ireland: Certain complex surgical techniques, paediatric specialist procedures, or rare cancer surgeries that are not performed at any volume in Irish hospitals but are available at specialist centres in the UK, Germany, the US, or elsewhere.
• Clinical trials or experimental treatments: Where a patient is accepted onto a clinical trial or access programme for an experimental treatment that is not available in Ireland.
• Specialist second opinions on rare conditions: Where a patient has a rare condition and no Irish consultant has sufficient expertise to provide a meaningful second opinion, but a recognised international expert can do so at a specialist overseas centre.

What evidence is required for Scenario 1

To support a Scenario 1 claim — where you are claiming travel and accommodation alongside treatment costs — you need documentary evidence confirming that the treatment was not available in Ireland. The most robust evidence is a letter from an Irish consultant confirming:

• The specific treatment required.
• That the consultant is not aware of the treatment being available in Ireland.
• That the consultant has referred the patient to the overseas specialist or is aware of the patient attending abroad for this reason.

Without this type of consultant letter, a Scenario 1 travel and accommodation claim is very difficult to sustain in a Revenue compliance review. If Revenue queries the claim, they will expect documentary confirmation that the treatment could not have been obtained domestically.

What travel and accommodation costs qualify under Scenario 1

Where Scenario 1 applies, the following costs alongside treatment qualify:

• Flights: Economy class airfare from Ireland to the treatment destination and return. Business class upgrades do not qualify as the qualifying standard is the reasonable cost of travel, not a premium option.
• Rail travel: Train tickets, including Eurostar or other rail connections where relevant.
• Accommodation near the treatment centre: Reasonable hotel or apartment costs for nights spent near the overseas treatment centre during the treatment period. Luxury hotels may be partially disallowed if Revenue considers the nightly rate unreasonable — aim to stay near the treatment location at a standard rate hotel.
• Ground transport to and from the overseas treatment centre: Taxis, airport buses, or other transport directly connected with attending for treatment.

Scenario 2: treatment available in Ireland, chosen abroad

Where a patient elects to receive treatment abroad for reasons of personal preference, cost, familiarity, or convenience — but the same or equivalent treatment is available in Ireland — only the treatment costs themselves qualify as health expenses. Travel and accommodation costs associated with the overseas trip do not qualify.

The most common scenarios in this category include:

• Dental tourism: A patient travels to Hungary, Poland, or another country for dental implants, crowns, or other restorative dental work at lower cost. The dental treatment costs qualify (subject to the normal Appendix 2 rules and Med 2 requirements for non-routine dental work); flights and hotels do not.
• Elective surgery abroad: A patient travels abroad for knee replacement, hip replacement, cataract surgery, or other procedures that are routinely performed in Irish hospitals. The surgery cost qualifies; travel and accommodation do not.
• Cosmetic procedures abroad: Where the procedure is cosmetic in nature, neither the treatment cost nor travel qualifies — cosmetic procedures are excluded from s.469 TCA 1997 entirely.

Patients in Scenario 2 should be careful not to claim flights and hotel as health expenses — if Revenue reviews the claim and determines the treatment was available in Ireland, they will disallow the travel and accommodation and may require repayment of the over-claimed relief with interest.

Converting foreign currency costs to euro

Foreign medical bills are typically invoiced in the local currency of the treatment country — sterling, euros (for eurozone countries), US dollars, or other currencies. For Irish income tax purposes, convert foreign currency costs to euro using the exchange rate applicable on the date of payment.

The most straightforward source for historical exchange rates is the European Central Bank (ECB) reference rate, available at ecb.europa.eu. Where you made multiple payments on different dates, use the ECB rate for each payment date. Document the source of the exchange rate used alongside the foreign currency invoice and the converted euro amount — this provides a clear audit trail if Revenue requests it.

Where bank statements show the actual euro amount charged (because the bank converted the payment at the point of transaction), the bank’s converted euro amount on the statement is acceptable evidence of the euro cost and can be used directly without a separate currency conversion calculation.

How to claim overseas medical treatment in myAccount

After converting all foreign currency amounts to euro and assembling the supporting documentation — overseas clinic invoices, Irish consultant referral or confirmation letter, travel and accommodation receipts (for Scenario 1), exchange rate documentation — log in to myAccount at revenue.ie. Navigate to PAYE Services → Review your Tax and select the relevant year. Enter the total qualifying amount under Health Expenses. Retain all documentation for six years.

Scenarios

Common Mistakes to Avoid

• ✗Claiming flights and accommodation for dental tourism or elective surgery that was available in Ireland — only treatment costs qualify in Scenario 2.
• ✗Not obtaining a consultant letter confirming unavailability in Ireland before filing a Scenario 1 travel claim — this letter is essential and very difficult to obtain retrospectively.
• ✗Not documenting the exchange rate used to convert foreign currency costs — retain the ECB rate or bank conversion evidence alongside the foreign invoice.

When This Relief Does Not Apply

Key Takeaways

• ➤The two scenarios are fundamentally different: treatment unavailable in Ireland = travel qualifies; treatment available in Ireland = travel does not qualify.
• ➤For Scenario 1, obtain an Irish consultant letter confirming unavailability before travelling if at all possible.
• ➤Convert foreign currency invoices to euro using the ECB rate on the date of payment.

Frequently Asked Questions

Related Guides

• Dental implants and periodontal treatment tax relief
• Crowns and root canal tax relief
• Complete guide to medical expenses relief
• Private consultant fees tax relief