Borderwise Booklets
Issue 1
10TH January 2007
Going South – Health
©
NIACAB (Northern Ireland Association of Citizens Advice Bureaux)
This booklet provides
general advice and information for people living in Northern Ireland but want
to move to the Republic of Ireland (ROI). It describes the health services
which are available in ROI and explains how these services are organised,
delivered and what provisions are available.
S3 Going South – Health
This factsheet
describes the health services which are available in the Republic of Ireland
(ROI). It explains how health services are organised and delivered and about
your entitlement to free or subsidised services. You may get further
information from the addresses and websites listed.
The information
in this leaflet applies to you if you are a citizen of any member state of the
European Economic Area (EEA) or Switzerland (The EEA is the 27 EU member states
plus Iceland, Liechtenstein and Norway) If you are a citizen of another country
and you are lawfully resident in ROI, you may be entitled to some or all of the
services described.
The information
in this leaflet was compiled in November 2007.
Organisation of Health Services
The Department of Health
and Children is responsible for health policy. Health and personal social services in Ireland are delivered by the Health Service Executive, through a network of Local Health
Offices, health centres and clinics. There are four Health Service Executive
Administrative Areas;
·
Health Service Executive:
Dublin Mid-Leinster: Dublin city south of the River Liffey, south Dublin county, Wicklow, Kildare, Longford, Westmeath, Laois, Offally
·
Health Service Executive:
Dublin North East: Dublin City north of the River Liffey, the community of
Fingal county, Louth, Meath, Cavan, Monaghan
·
Health Service Executive:
West: Limerick, Clare, Tipperary (North Riding), Galway, Mayo, Roscommon,
Donegal, Sligo, Leitrim
·
Health Service Executive:
South: Carlow, Kilkenny, Tipperary (South Riding) Waterford, Wexford, Cork, Kerry
Nationally,
responsibility for the provision of health and personal social services lies
with;
·
National Hospitals Office (NHO) who provide public hospital
and ambulance services
·
Primary, Community and Continuing Care who provide care in
the community
·
Population Health who promote and protect the health of the
population.
These services
are delivered through the four
HSE Administrative regions set out above.
For more information
contact:
Health Service
Executive
Oak House,
Limetree Avenue,
Millenium Park,
Naas,
Co. Kildare
Tel: 045 880400
www.hse.ie
Entitlement to Health Services
The population is
divided into two groups for the purposes of entitlement to health services –
medical card holders and non-medical card holders. There are two kinds of
medical card – a standard medical card or a GP visit card. If you have a
standard medical card, you are entitled to
- free GP
services,
- free prescribed
drugs and medicines,
- free in-patient
and out-patient public hospital services (but you may have to pay
long-stay maintenance charges if you are in hospital for more than 30
days)
- free dental,
ophthalmic and aural services
- free public
health nursing services and
- free maternity
and infant care services
Non medical card
holders are entitled to
- subsidised
prescribed drugs and medicines,
- free in-patient
and out-patient public hospital services (but you may have to pay short
stay and long-stay maintenance charges and out-patient charges) and
- free maternity
and infant care services
Medical Cards
A medical card
issued by the Health Service Executive (HSE) in Ireland enables the bearer to
receive certain health services free of charge; however you must pass a means
test in order to qualify. If you
are issued with a medical card, the card would normally cover you and your
dependent spouse and child dependants. Unless you have a
medical card, visits to family doctors in Ireland are not free. The GP Visit
Card was announced in 2005 as an initiative to assist those who did not qualify
for a medical card on income grounds but for whom the cost of visiting a GP was
often prohibitively high. Eligibility for all GP Visit Cards is means
tested you must be ordinarily resident in Ireland.
Applying
for a Medical Card or GP visit card
In order to apply
for a Medical card you must complete an MC1 application form, or MC2 for those
aged 70 and over. You can obtain an application form and a list of
participating doctors from your local health centre
or at the Social Welfare Local Office. To
apply for a GP Visit Card, you use the same application form as that for a
medical card. While your GP Visit Card application is being processed, the HSE
will also assess your entitlement for a full medical card.
Frontier
Workers
Workers who
continue to reside in Northern Ireland but work in the Republic of Ireland may be entitled to a medical card but this will be subject to a means test. Frontier
workers must apply in the usual way and they will be advised of their
entitlement. For those living in NI who wish to move permanently to ROI they
will automatically qualify for a medical card if they are aged 70 or over or if
they are transferring a contribution based social security payment from NI. For
further information on entitlement to health services contact;
Parkgate St.
Business Centre, Dublin 8
Phone: +353 (0)1 635 2500
Fax: 01 635 2823
www.hse.ie
What types of treatment are
available?
GP Services
You are entitled
to free GP services if you have a standard medical card or a doctor only
medical card. You may choose a GP who is involved in the medical card scheme
and is willing to take you as a patient. If you have problems finding a GP,
the HSE should be able to help you find one. You may find a list of GPs at www.icgp.ie.
If you do not
have a medical card you make private arrangements with a GP and you pay for the
services provided. You may be entitled to some free services, for example,
maternity and infant welfare services and some immunisation services
Prescribed drugs and medicines
You are entitled
to free prescribed drugs and medicines if you have a standard medical card.
If you do not
have a standard medical card, you are entitled to subsidised prescribed drugs
and medicines under the Drugs Payment Scheme. This scheme operates on a
calendar month basis. It aims to ensure that you do not have to pay above a
certain amount for drugs and medicines for use in any calendar month. The
current maximum you (and your dependants) should have to spend is €85 a month.
Approved drugs
and medicines
The drugs and
medicines which may be free or subsidised are subject to approval by the
Department of Health and Children. Generally, they must be approved for use by
the relevant regulatory body (the Irish Medicines Board in Ireland) and they must be available only on prescription. This means that certain items
which can be bought over the counter are excluded from the schemes. The list
of items covered is changed frequently.
Long-term
Illness Scheme
If you are
suffering from one of a list of prescribed diseases or disabilities you are
entitled to the drugs, medicines and medical and surgical aids and appliances
prescribed for that disease free of charge.
Dental, Optical and Aural services
You may be
entitled to free or subsidised dental, optical and aural services under two
different schemes.
If you have
enough PRSI contributions (see Leaflet S1 Going South – Work), you may
be entitled to help with dental, optical and aural costs from the Department of
Social and Family Affairs. You may combine national insurance contributions
paid in the North with your PRSI contributions in order to qualify. Generally,
the services are provided by private practitioners and you should apply in
advance of treatment. Private practitioners usually have information and
application forms.
Medical card
holders are legally entitled to free dental, optical and aural services from
the HSE but, in practice, the availability of these services varies from area
to area and priority may be given to certain groups, for example, children. If
you are eligible for the DSFA scheme, you are expected to avail of it. The HSE
sometimes provides the services directly and sometimes the services are
provided through private practitioners.
Pre-school
children and national school children referred from the child health service
and school health service examinations are entitled to these services from the
HSE free of charge whether or not they have medical cards.
Services for Mothers and Children
Everyone is
entitled to free maternity services for the period of pregnancy and for 6 weeks
after the birth. This service is provided by your own GP - you are entitled to
this service even if you do not have a medical card. The baby is entitled to
free GP services for the first 6 weeks as well. Hospital services for the birth
are free of charge in a public ward and the in-patient and out-patient charges
do not apply.
If the baby is to
be born at home the HSE is obliged to provide obstetrical requisites free of
charge but is not obliged to provide medical and nursing services for a home
birth
Expectant and
nursing mothers who have standard medical cards and children under the age of 5
whose parents are unable to provide it may get supplies of milk from the HSE.
Child Health
Services
Child health
services are provided at health centres and in schools. These services are
free of charge and include immunisation services, developmental paediatric
examinations, visits by public health nurses, and dental optical and aural
services.
Hospital Services
Everyone is
entitled to free treatment in a public hospital but some people may have to pay
towards the cost of maintenance in public hospitals. If you go into a private
ward of a public hospital or into a private hospital, you must pay for both
treatment and maintenance.
Maintenance
Charges for short stay in hospital
The
current charge is €55 a night up to a maximum of €550 a year. So, if you go into a public bed in a
hospital, you may be charged €550 for the first ten days. Then you are not
charged until you have been in for a total of 30 days – at this stage the long
stay charges come into effect.
The short stay charges do not apply to the following
groups:
·
Standard medical card
holders – but they may apply to holders of doctor only medical cards unless
they are in one of the other exempted groups
·
people receiving
treatment for prescribed infectious diseases
·
people who are subject
to long stay charges
·
Children up to six
weeks of age, children suffering from prescribed diseases and disabilities and
children referred for treatment from child health clinics and school board
examinations
·
People who are
entitled to hospital services because of EU Regulations
·
Women receiving
services in respect of motherhood
In cases of
undue hardship the HSE may decide not to apply charges.
Long Stay
Charges
If you are in
hospital for 30 days, you may have to pay long stay charges. These apply in
acute hospitals and in long stay care facilities. The maximum charge is €120 a
week. Long stay charges are not payable by the following groups:
- people aged
under 18
- women receiving
maternity services
- people
involuntarily detained under the mental health legislation
- people in acute
hospitals (including psychiatric hospitals) who require medically acute
care and treatment
- people who are
suffering from Hepatitis C as a result of blood transfusions
Charges for
Accident and Emergency Services in Public Hospitals
If you go to the
accident and emergency or casualty department of a public hospital without
being referred there by a GP, you may be charged (currently €55). There is no
charge if you are referred by a GP. This charge does not apply to broadly the
same groups as are exempt from the short stay in-patient charges.
Community Care Services
Community care
services for people who need them are provided by the HSE. They may be
provided directly or through a voluntary or community organisation. Community
care services is the term used to describe services which enable people who are
ill or have disabilities to remain at home.
Public Health
Nursing Service
Public health
nursing services may be provided free of charge by the HSE to older people,
children and people with disabilities.
Home Helps
Home helps may be
provided by the HSE or by a voluntary organisation to help older people and
families where a parent is ill or unable to cope. In practice, the
availability of home helps varies greatly throughout the country. You may be
asked to contribute towards the cost.
Other
community care services
The HSE provides
a range of other services including
- Speech and
Language therapy: mainly for pre-school and school going children who have
a speech or language disorder.
- Occupational
therapy: mainly for older people and people with disabilities
- Psychology
services: mainly for children with learning difficulties
- Community
Physiotherapy: mainly for older people and people with disabilities
- Day care
centre: mainly for older people
- Housing aid for
older people – this involves essential repairs to housing
- Laundry
services, means on wheels and chiropody services: mainly for older people
Tax relief on medical expenses
You may be able
to claim tax relief at your marginal rate of tax on medical expenses such as
dental costs, GP costs, costs of private hospital treatment and nursing home
care. There are detailed rules about precisely which costs attract tax
relief. You may get further information from
www.revenue.ie