Health Services in Ireland

The Department of Health is responsible for health policy. Health and social services are delivered by the Health Service Executive (HSE) through a network of local health offices, health centres and clinics.

Entitlement to Health Services

Entitlement to health services is normally based on residency and means. Any person regardless of nationality who is accepted by the HSE as being ‘ordinarily resident’ in Ireland is entitled to healthcare.

The population is divided into two groups for the purposes of entitlement to health services –medical card holders and non-medical card holders. A person may have full or limited eligibility. There are three types of medical cards; a standard medical card, a GP visit card and a Medical card/GP visit card for people over age 70. [A medical card irrespective of how granted gives the same entitlement, entitlement differs for GP visit card holders]

MEDICAL CARD HOLDERS

A medical card, issued by the Health Service Executive (HSE), entitles the bearer to receive certain health services free of charge subject to certain personal criteria including a means test. Unless you are the holder of a medical card, visits to a family doctor in Ireland are not free.

Medical card eligibility is based on an assessment of means. To qualify, your weekly income must be below the income threshold. Any income, savings, investments and property (except for your own home) are taken into account in the means test. Outgoings such as rent, mortgage, childcare costs, travel to work costs are also considered in assessment. It is important that you give as much information as possible with your application including dependants, mortgage payments, medical expenses etc.

There are different means test rules for a person who is applying and is aged 70, or over, as the income guidelines are greatly increased.

Other exceptional circumstances are always considered where a person or family has personal or social issues causing undue financial hardship. The card may be granted for the whole family, or for individual members of a family on the grounds of undue financial hardship.

The same application form is used for both the Medical Card and the GP Visit Card.

If you are not eligible for a medical card, you may be eligible for a GP Visit Card or the Long-Term Illness Scheme

GP visit Card: A GP Visit Cards allows individuals and families in Ireland to visit their family doctor for free. Only the cost of visits to your family doctor is free; you must pay for prescribed drugs, medicines and other health services similar to others who don't have a Medical Card. If you have a GP Visit Card you should also apply for a Drugs Payment Scheme Card if you don't already have one. The income guidelines for GP Visit Cards are higher than the Medical Card and the allowances for rent, mortgage and childcare bring many people's income within the guidelines.

You will get a GP Visit Card if the combined means of you and your spouse/partner is below HSE income guidelines. If your assessed means are still more than the GP Visit Card guidelines you may still qualify for a GP Visit Card on the grounds that your medical costs causes you undue financial hardship. Such an example would be if you had an ongoing medical condition that required exceptional and regular medical treatment, or visits to the doctor or hospital.

If you have a medical card you are entitled to:-

Doctor Visits - a range of family doctor or GP services free of charge from a chosen doctor contracted to the HSE in your local area;
Prescription Medicines: The supply of prescribed approved medicines, aids and appliances like wheelchairs, crutches etc. In some circumstances a deposit may be required for aids and appliances which will be refunded on return of the aid or appliance. A €2.50 prescription charge applies for each item prescribed to all medical card patients;
Certain Dental, Ophthalmic (Eye), and Aural (Ear) health services;
Hospital Care - all in-patient services in public wards in public hospitals, including public consultant services;
Hospital Visits [Outpatient Services] - These include accident and emergency services as well as planned services provided on an outpatient basis. For example person may be referred by GP for specialist assessment by a consultant. All out-patient services in public hospitals, including public consultant services;
Medical & Midwifery Care for Mothers, including health care related to pregnancy and the care of the child for six weeks after birth;
Some personal and social care services, for example, public health nursing, social work services and other community care services based on client need.

You may also be entitled to the following additional benefits if you have a Medical Card:

No need to pay the health portion of your social insurance (PRSI);
Free transport to school for children who live 3 miles or more from the nearest school;
Exemption from state examination fees in public second-level schools;
Financial help with buying school books. The benefits above are available from the relevant Government Department.

Applying for a Medical Card

The quickest way to obtain a medical card is to use the online form at www.hse.ie to enter your details. You will need access to a printer to print the application pack. You may also obtain an application form and a list of participating doctors from your local health centre.

NON MEDICAL CARD HOLDERS

If you don’t have a medical card you are entitled to:-

Subsidised prescribed drugs and medicines;
In-Patient and Out –Patient public hospital services (but you may be subject to short stay and long stay maintenance charges and out-patient charges);
Maternity and Infant care services.

HEALTHCARE FOR FRONTIER WORKERS

Frontier workers must apply in the usual way and they will be advised of their entitlement. They will have to submit evidence [Eform or S1], or if from the UK, evidence of entitlement under EU regulations with proof of being insured in that State.

Northern Ireland Residents working in Ireland:

Are entitled to NHS care as they are legally resident in Northern Ireland

Ireland Residents working in Northern Ireland:

Are entitled to an NHS medical card, however their spouse and dependents are not [except necessary care for dependants on temporary stay]
Are eligible for free GP services in Northern Ireland
Are eligible to register with an NHS Dentist
Are eligible for maternity services from a GP, a midwife and an obstetrician in a hospital in Northern Ireland
Are eligible for an Irish Medical card under EU entitlement without a means test for themselves and family member resident with them. This is provided they are not also insured in Ireland.

Pensioners

For those living in Northern Ireland, and are over age 70, and who wish to move permanently to Ireland they will automatically qualify for a medical card if they are transferring a contribution based social security payment from Northern Ireland. It is immaterial whether under or over 70 but the social security payment has to carry healthcare entitlement with it under EU regulations.

For more information visit www.hse.ie or Local 1890 252 919