A highly critical report has found people were left to borrow money or fall into debt because of difficulty recouping money owed to them by the HSE.
Under a series of schemes patients are entitled to undergo medical treatment abroad and have the costs repaid if the treatment isn't available here or isn't available in a timely manner.
However, this report has shown the HSE has refused to reimburse people for medical treatment they sought legitimately overseas.
An investigation by the Ombudsman found in many cases, patients had to fight to have the money repaid.
The HSE has welcomed the publication of the report and says it will implement a series of recommendations made in it.
Ombudsman Ger Deering says the delayed repayments left many out of pocket and in debt.
"People who use these schemes will generally be people with limited means. Generally speaking, other people may well have health insurance, or may have a way of getting these things done privately.
"So the fact that people are entitled to the schemes, most likely means they are of limited means. That was the issue for some people where they borrowed money from a relative, or from the Credit Union, in fairly certian knowledge in their view that it was just a matter of time that they would pay for their treatment and claim the money back."
