{"id":10304,"date":"2022-07-08T15:28:05","date_gmt":"2022-07-08T15:28:05","guid":{"rendered":"http:\/\/legalblog.ie\/medical-cards\/"},"modified":"2024-02-25T20:50:51","modified_gmt":"2024-02-25T20:50:51","slug":"medical-cards","status":"publish","type":"post","link":"https:\/\/legalblog.ie\/medical-cards\/","title":{"rendered":"Medical Cards General"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_63 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title \" >Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Medical_Card\" title=\"Medical Card\">Medical Card<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Other_Entitlements\" title=\"Other Entitlements\">Other Entitlements<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Residence_Issues\" title=\"Residence Issues\">Residence Issues<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Applcation_for_Registration\" title=\"Applcation for Registration\">Applcation for Registration<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/legalblog.ie\/medical-cards\/#GMS_Contracts\" title=\"GMS Contracts\">GMS Contracts<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Qualification\" title=\"Qualification\">Qualification<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Sepcial_Qualification\" title=\"Sepcial Qualification\">Sepcial Qualification<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Means_for_Qualification\" title=\"Means for Qualification\">Means for Qualification<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Income_Disregarded\" title=\"Income Disregarded\">Income Disregarded<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/legalblog.ie\/medical-cards\/#Capital_Means\" title=\"Capital Means\">Capital Means<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/legalblog.ie\/medical-cards\/#GP_Practice\" title=\"GP Practice\">GP Practice<\/a><\/li><\/ul><\/nav><\/div>\n<h3><span class=\"ez-toc-section\" id=\"Medical_Card\"><\/span>Medical Card<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Entitlement to health services is based primarily on residence and compliance with the means test.\u00a0 Unlike other states, there is no comprehensive social insurance payment system linked to health services.<\/p>\n<p>Any resident who satisfies the HSE\u00a0 that he is ordinarily is entitled to either full eligibility or limited eligibility for health services.\u00a0 Full eligibility is available to Medical Card holders.\u00a0 A limited eligibility is entitled to the balance of the population<\/p>\n<p>Persons with full eligibility for health services are entitled to a Medical Card.\u00a0 A Medical Card carries the following entitlement:<\/p>\n<ul>\n<li>Free GP services<\/li>\n<li>Prescribed drugs and medicine<\/li>\n<li>Public hospital services<\/li>\n<li>Dental, optical and aural services<\/li>\n<li>Maternity and infant care services<\/li>\n<li>A range of community care and personal social services.<\/li>\n<\/ul>\n<p>The prescribed drugs and services have been subject to a \u20ac0.50 charge per item since 2010.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Other_Entitlements\"><\/span>Other Entitlements<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Persons who are not entitled to a Medical Card are entitled to free public hospital services.\u00a0 This is subject to an obligation to pay in-patient and out-patient hospital charges.\u00a0 They are entitled to subsidise prescribed drugs and medicines, infants and maternity care services.\u00a0 They may also be entitled to free or subsidised community care or personal social services.<\/p>\n<p>A further category of entitlement is granted by a GP Visit Card.\u00a0 This gives entitlement to free GP services but limited other entitlements.<\/p>\n<p>There are certain services that are available irrespective of means or whether or not a medical card is held.\u00a0 Persons with certain long-term illnesses are entitled to drugs and medicines free of charge for that illness.\u00a0 Child health services are available universally.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Residence_Issues\"><\/span>Residence Issues<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ordinary residence requires proof of long-term residence in the state.\u00a0 This will typically be shown by evidence of permanency such as a residence, residence visa, bank accounts etc.\u00a0 Nationality is not a key test.\u00a0 In the case of non-EU nationals, dependents must satisfy the residence test as well.<\/p>\n<p>EU Citizens living in Ireland who are entitled to a Social Security Pension from another state may be entitled to a Medical Card without having to satisfy a means test.\u00a0 They must not have any earned or unearned income in addition to pension income.<\/p>\n<p>Generally, persons working in one state are entitled to the health services in the state where they live and work.\u00a0 Accordingly, persons who are resident in Ireland but working in the United Kingdom may be entitled to Medical Cards without means test on the basis of UK entitlement.<\/p>\n<p>Short-term visitors from EU states are entitled to urgent medical treatment without charge.\u00a0 \u00a0Entitlement is decided by presentation of the European health insurance card.\u00a0 UK residents may establish entitlement by proof of UK residence.\u00a0 Non-EU visitors may be charged the cost of treatment provided.\u00a0 More favourable arrangements exist with some states.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Applcation_for_Registration\"><\/span>Applcation for Registration<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>General Practitioners register with the General Medical Services Scheme and enter contracts with the HSE to provide services.\u00a0 Patients may usually choose their doctor from a GMS panel, provided the doctor is willing to take them as patients.<\/p>\n<p>Generally, services are provided by the registered doctor, although in some circumstances, services may be provided by other doctors in an emergency.\u00a0 Doctors must treat GMS patients on the same terms as other patients.<\/p>\n<p>Application for Medical Cards is now made to the local health office.\u00a0 A doctor should not have more than 2000 GMS patients. Medical Cards may be issued on the basis of certain terms and are subject to review.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"GMS_Contracts\"><\/span>GMS Contracts<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The GMS contract specifies the range of services the doctor must provide.\u00a0 This includes<\/p>\n<ul>\n<li>consultation services at his surgery or in the patient\\&#8217;s home.<\/li>\n<li>proper and necessary treatment of a kind normally undertaken<\/li>\n<li>issuing of medical certificates where required.<\/li>\n<li>drugs, medicines and appliances, and prescriptions where required.<\/li>\n<\/ul>\n<p>GPs must dispense drugs if they are more than 3 miles from the nearest pharmacy.\u00a0 Dispensing doctors are accordingly found in rural areas.<\/p>\n<p>Certain services are not required to be provided free of charge.\u00a0 These may include, for example, medical check-ups for external purposes.\u00a0 Apart from this, services must be provided on the same terms and principles as for fee-paying patients.<\/p>\n<p>Doctors on the \u00a0GMS scheme must provide emergency services for their own patients.\u00a0 A rota system may provide for out-of-hours cases.<\/p>\n<p>If a person moves to HSE administrative areas, they should register with a new doctor.\u00a0 The existing card holds for three months. \u00a0They must liaise with the relevant local health office.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Qualification\"><\/span>Qualification<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Entitlement to a Medical Card requires that weekly income is below a certain figure.\u00a0 This is relative to family size.\u00a0 See below in respect of the means test. They are generally issued for three years, subject to review.<\/p>\n<p>Generally, a dependent spouse and children are covered for the same range of health services.<\/p>\n<p>Medical Card holders are subject to the Universal Social Charge on income other than HSE and social welfare income.\u00a0 There is a maximum rate of 4%.\u00a0 There is an exemption for persons earning less than \u20ac10,036 per annum.<\/p>\n<p>There is an obligation to inform the HSE of any changes in circumstances relevant to an entitlement of a Medical Card. If the periodic HSE review is not responded to, the card may not be reissued.\u00a0 Entitlement continues on an unexpired card while the review is taking place.<\/p>\n<p>Full-time students between the ages of 16 and 25 years who are financially independent of their parents may be entitled to qualify for a Medical Card in their own right.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Sepcial_Qualification\"><\/span>Sepcial Qualification<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>A GP Visit Card allows free GP visits.\u00a0 The means test is pitched at 50% higher than for the general Medical Card.<\/p>\n<p>Under certain back-to-work and labour market activation schemes, a person may be entitled to retain a Medical Card for up to three years after commencing or resuming employment.\u00a0 See separately the sections on social welfare.<\/p>\n<p>Medical Cardholders are subject to a \u20ac1.50 charge per prescription item with a monthly ceiling of \u20ac90.50.\u00a0 HSE issues refunds if prescription charges exceed \u20ac19.50 per month.<\/p>\n<p>Certain Medical Card holders did not pay the prescription charges, including children in the care of HSE who have their own card.<\/p>\n<ul>\n<li>Methadone supplies,<\/li>\n<li>items supplied under long-term illness scheme,<\/li>\n<li>persons on high tech product scheme.<\/li>\n<\/ul>\n<p>This does not apply to children in HSE care.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Means_for_Qualification\"><\/span>Means for Qualification<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>In each case, this excludes income from savings and similar investments whose principal value is \u20ac36,000 or less, in the case of a single person or \u20ac72,000 or less in the case of a couple. The limits may be reviewed by the Minister for Finance to reflect changes in the Consumer Price Index.<\/p>\n<p>In calculating gross income, only net income from property is included.\u00a0 This is gross rental income less necessarily incurred associated costs. The Minister may, by regulations, prescribe other payments, such as compensation and redress payments, which are excluded from the calculation of income.<\/p>\n<p>The appeals process under the Health Act applies to persons who apply for a medical card under the legislation.<\/p>\n<p>The HSE guidelines allow a Medical Card to be issued in some circumstances, even if income levels exceed the means test if the income is derived solely from social welfare allowances and benefits and HSE allowances.<\/p>\n<p>In the case of persons under 70 years, the means test is based on a weekly income limit.\u00a0 This is income net of tax, universal social charge and PRSI.\u00a0 The test provides a threshold for a single person, together with increments for married or cohabiting parents (including lone parents with dependent children) and allowances for children.<\/p>\n<p>Deductions may be permitted for childcare costs, rental and mortgage payments.\u00a0 This is a matter of assessment, and there are no monetary guidelines.\u00a0 Deductions may also be allowed for costs and travelling to work.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Income_Disregarded\"><\/span>Income Disregarded<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The following income is ignored in Medical Card assessments.<\/p>\n<ul>\n<li>certain civil compensation payments, including from Redress Boards.<\/li>\n<li>certain HSE payments, including foster care allowance, mobility allowance, weekly supplements under supplementary welfare allowance<\/li>\n<li>Social welfare payments, including child benefits, family income supplement, fuel allowance, over 80 allowance, domiciliary care allowance<\/li>\n<li>certain third-level maintenance grants,<\/li>\n<li>certain rehabilitation maintenance allowance,<\/li>\n<li>earnings from employment of a rehabilitative nature up to \u20ac120 euro a week.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Capital_Means\"><\/span>Capital Means<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Capital from savings is taken into account. This does not apply to the family home.\u00a0 Saving up to \u20ac36,000 for a single person and \u20ac72,000 for a married couple are disregarded.<\/p>\n<p>There is a deemed rate of return, which is deemed to increase the weekly means for the purpose of assessment.<\/p>\n<ul>\n<li>Above \u20ac36000 (and \u20ac72,000)<\/li>\n<li>the next \u20ac10,000 assessed at 5.2%.<\/li>\n<li>the next \u20ac20,000 is assessed at 10.4%.<\/li>\n<li>the balance is assessed at 20.8%.<\/li>\n<\/ul>\n<p>Unused property other than the family home may be assessed notionally.\u00a0 There may be a notional assessment of the market rent or the percentage of the capital value per the above table.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"GP_Practice\"><\/span>GP Practice<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The GP practice must generally be within 7 miles of the applicant&#8217;s place of residence.\u00a0 The GP must accept the patient.<\/p>\n<p>There is an appeal from a decision of the local health office to an appeals officer of the HSE area.\u00a0The Health General Practitioner Service Act 2014 amends existing legislation in relation to appeals.<\/p>\n<p>The appeals process was extended to decisions regarding the operation of the new GP service for children aged five years and younger.\u00a0 The director general of the HSE appoints a person to carry out the appeal.\u00a0 The person undertaking the appeal is to be of a grade senior to that of the original decision-maker.<\/p>\n<p>The existing criteria for ordinary residence in the Health Act are amended to effect changes to include the new GP service for all children aged five and younger.\u00a0 Children who have not yet attained the age of six are removed from the existing GP service under the medical card scheme and are covered by the new service.<\/p>\n<!--themify_builder_content-->\n<div id=\"themify_builder_content-10304\" data-postid=\"10304\" class=\"themify_builder_content themify_builder_content-10304 themify_builder tf_clear\">\n    <\/div>\n<!--\/themify_builder_content-->\n","protected":false},"excerpt":{"rendered":"<p>Medical Card Entitlement to health services is based primarily on residence and compliance with the means test.\u00a0 Unlike other states, there is no comprehensive social insurance payment system linked to health services. Any resident who satisfies the HSE\u00a0 that he is ordinarily is entitled to either full eligibility or limited eligibility for health services.\u00a0 Full [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[137],"tags":[],"_links":{"self":[{"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/posts\/10304"}],"collection":[{"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/comments?post=10304"}],"version-history":[{"count":23,"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/posts\/10304\/revisions"}],"predecessor-version":[{"id":32308,"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/posts\/10304\/revisions\/32308"}],"wp:attachment":[{"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/media?parent=10304"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/categories?post=10304"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/legalblog.ie\/wp-json\/wp\/v2\/tags?post=10304"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}