Entitlement to public health care

Categories 1 and 2

There are two categories of entitlement to public health care in Ireland. Category 1 eligibility (a Medical Card) entitles you to the full range of medical services without charge; Category 2 entitles you to only a limited range of services without charge.

Medical Card

EEA citizens resident in Ireland but insured in another EEA country automatically receive a Medical Card, as do pensioners and those seeking work in Ireland. Otherwise, eligibility for Medical Cards is means tested, i.e. assessed according to your income. The upper income limit is adjusted annually in January and varies according to age, family status and other factors, but in general Category 1 eligibility applies to those with low incomes (officially around 36 per cent of the population).

A Medical Card entitles you to free GP services; prescribed drugs and medicines; in-patient and out-patient services in a public hospital; dental, optical and aural services and appliances; and maternity and infant care during pregnancy and for up to six weeks after birth. Medical Card holders may also be able to get expenses involved in travelling to and from hospital refunded, although this scheme has been cut back in recent years.

Category 2

Everyone else who’s entitled to public health care falls into Category 2, which means that they must pay for medicines and prescriptions, routine dental, optical or aural treatment, as well as for visits to a doctor. Maternity care and public hospital out-patient services are free, but charges apply to in-patient accommodation and visits to Accident & Emergency departments.

If you aren’t entitled to a Medical Card, you’re usually sent a letter by the Department of Health and Children confirming your entitlement to Category 2 benefits.

Retirees & the Elderly

Many people are ill-prepared for old age and the possibility of health problems, although you’re better provided for in Ireland than in many other countries. All retirees over 65, whether or not they have a Medical Card, are entitled to regular visits by a public health nurse and, if required, occupational therapy. Meals on wheels and a home help service are provided by voluntary organisations on behalf of the Health Board, usually for a small fee (a list of voluntary organisations is available from the National Social Service Board, Tel. 01-605 9000).

There are also grants for security devices for elderly people living alone, although these aren’t usually paid directly to individuals. Other schemes offer home improvement grants, free draught proofing and insulation (in some parts of the country), and house alterations for disabled people. The only universal benefit for elderly people is free travel, for which everyone over 66 qualifies, but even that has various conditions attached.