Entitlement to health services is primarily based on residency and means, rather than on your payment of tax or pay-related social insurance (PRSI). Any person, regardless of nationality, who is accepted by the Health Service Executive (HSE) as being ordinarily resident in Ireland is entitled to either full eligibility (Category 1; medical card holders) or limited eligibility (Category 2) for health services.
Visitors to Ireland may be entitled to free and/or subsidised services in certain circumstances.
The resident population is divided into two groups for the purposes of their eligibility for health services - medical card holders and non-medical card holders.
Medical Card holders
If you have a medical card, you are entitled to:
- free GP services
- prescribed drugs and medicines, subject to a charge per item prescribed
- public hospital services
- dental, optical and aural services
- maternity and infant care services
- a range of community care and personal social services.
Non-Medical Card holders
If you do not have a medical card, you are entitled to free public hospital services but you may have to pay in-patient and out-patient hospital charges. You are also entitled to subsidised prescribed drugs and medicines and maternity and infant care services and you may be entitled to free or subsidised community care and personal social services.
Unless you hold a GP Visit Card, you are not entitled to free GP services.
You may be entitled to some community care and personal social services.
General health services
There are certain general health services that are available to people on the basis of their need or health status rather than on whether they have a medical card or not.
- People who qualify for the Long Term Illness Scheme are entitled to get the drugs and medicines for the treatment of that illness free of charge.
- Child health services are available to all children
- Health promotion is aimed at the entire population.
Establishing Ordinary Residency
If you are coming to live in Ireland or returning here to live, you must satisfy the Health Service Executive (HSE) that you are "ordinarily resident".
To establish that a person is ordinarily resident a Health Service Executive (HSE) may require:
- Proof of property purchase or rental, including evidence that the property in question is the person's principal residence.
- Evidence of transfer of funds, bank accounts, pensions etc.
- A residence permit or visa.
- A work permit or visa, statements from employers etc.
- In some instances, the signing of an affidavit (a sworn written statement) by the applicant.
Any person, regardless of nationality, who is accepted by the Health Service Executive (HSE) as being ordinarily resident in Ireland is entitled to either full eligibility (Category 1, i.e. medical card holders) or limited eligibility (Category 2) for health services.
The fact that a non-EU national has established their eligibility for health services does not automatically mean that their dependants are also eligible.
Dependants of non-EU nationals may also have to satisfy the above requirements.
Under EU rules if you are living in Ireland and getting a Social Security Pension from another EU State you may be entitled to a medical card here without having to satisfy the usual means test provided you are not getting an Irish Social Welfare Pension and are not employed or self-employed here. If you have unearned income of more than €3,174.34 per year you may be regarded as self-employed and would have to satisfy a means test in order to medical card.
Generally, if you work in one Member State and live in another, you are entitled to get health services in the state where you live and where you work. This means that workers who live here but work in Northern Ireland are entitled to get medical cards here without a means test. Their families are also entitled to a medical card in Ireland without a means test provided the spouse is not employed or self-employed here.
A national of another EU Member State who is not covered for health services under EU rules should check their status as "ordinarily resident" with the Health Service Executive (HSE) in order to establish their eligibility for health services here.
Short-term Visitors to Ireland
- Visitors from EU Member States: are entitled to urgent medical treatment here without charge provided they present the European Health Insurance Card. Visitors from the United Kingdom do not require the European Health Insurance Card. Evidence of residence in the United Kingdom may be required e.g. social security documentation or driving licence.
- Visitors from Australia: are entitled to urgent medical treatment here on the same basis as non-medical card holders, i.e., they are subject to hospital charges. Visitors will, on presentation of suitable identification (passport/evidence of residence in Australia) be entitled to hospital services as a public patient and will be invoiced for the relevant hospital charge.
- Visitors from countries outside the EU: may be charged the full economic cost for any treatment provided here.
Further information is available from your Local Health Office.
The law on entitlement to public health services
The law on entitlement to health services in Ireland is quite complex. The main legislation is the Health Act 1970 as amended by a number of Acts including the Health (Amendment) Act 2005. The Health Act 1947 and the Health Act 1953 also contain provisions relating to entitlement. These Acts have all been amended several times.
Eligibility and entitlement
Under the Health Acts, the Health Service Executive (HSE) is obliged to provide certain services; for example, it must provide hospital services for everyone. Other services may be provided, for example, Home Help. The Department of Health take the view that you are 'eligible' for the various services and that this is not the same as being 'entitled' to them. The Ombudsman however does not accept this distinction though it has never been argued in a court.
Free and subsidised services
The legislation which requires the Health Service Executive (HSE) to provide services sometimes sets out that these must be free of charge to some or all recipients. Sometimes, the legislation allows for charges to be made. The fact that you must pay a contribution towards the cost of services does not change your basic entitlement to avail of those services.