Healthcare and Primary Medical Cover

Healthcare and Primary Medical Cover 2019-01-18T14:29:01+01:00

Project Description

MEDICAL CARD & GP VISIT CARD

  • Primary Medical Cover: A Medical Card entitles you to most health services free. A GP Visit Card covers the
    cost of visits to the doctor for your family. The means test for these cards is based on net income i.e. after the deduction of tax and PRSI; of reasonable expenses: (on rent or mortgage; on travel to work; on childcare and on regular weekly out-of-pocket medical expenses). Savings in excess of €36,000 (single) €72,000 (couple) are valued in the same way as in Social Welfare means-test. The cards will be granted if your family’s remaining income after these deductions does not exceed the following guidelines for 2019:
  • The cards will be granted if your family’s remaining income after these deductions does not exceed the following guidelines for 2019:
 Income Guidelines Medical Card GP Only
Under 66 66 and over Under 66 66 and over
Single living alone 184.00 201.50 304.00 333.00
Single living with family 164.00 173.50 271.00 286.00
Married or cohabiting couple (or single parent) 266.50 298.00 441.00 492.00
Additional Allowance for Dependent Children Medical Card GP Only
for each of first two children under 16 38.00 57.00
for third and each subsequent child under 16 41.00 61.50
for each of first two children over 16 39.00 58.50
for third and each subsequent child over 16 42.50 64.00
for each child over 16 in full time third level education (no grant) 78.00 117.00
  • The HSE will consider cases outside these guidelines on exceptional hardship grounds. Medical Card holders do not have to pay student exam fees. Persons with British or EU pensions, who have no Irish Social Welfare pension, generally qualify for the Medical Card regardless of income. Students will only qualify for a Medical Card in their own right if they have an independent income of at least e164 (this can include a student grant which would not count in the Medical Card means-test).
  • Persons aged 70+ all now qualify for free GP services, and qualify for a Medical Card if their gross weekly income is less than €500 per week (single), or €900 (couple). In the means test, the first €36,000 (single), €72,000 (couple) of savings and investments are disregarded. On the balance, you can opt that only the income actually earned will be counted, by submitting either a certificate of interest or details of the savings product. If significant savings are involved this is more favourable than using the Social Welfare method.
  • Children aged five and under qualify for a GP Card regardless of parents’ means (contact: www.gpvisitcard.ie, locall 1890 252919). Children in receipt of Domiciliary Care Allowance are automatically eligible for a Medical Card.
  • A 2.00 charge per prescription item applies to Medical Card holders (max 20 per month per family) but from March 2019 for those aged 70 and over it is 1.50 per item (max 15 per month). Prescription charges do not apply to those on the Long-term Illness Scheme.
  • Drug Refund: Any individual or family can get a refund on the cost of prescribed drugs used in any month in excess of 124
    (from March 2019) provided the drug is on the Government list.
  • General Hospital Entitlements: Everyone is entitled to public in-patient and out-patient hospital services. However, if you see a consultant privately, you will have to pay privately for any test or care arising, unless you give notice that you  wish to switch back to join the public waiting list for the treatment. The National Treatment Purchase Fund is now contacting Public Patients waiting longest across 50 different procedures, offering the option of having the procedure done immediately in another hospital as a private patient without charge.
  • Charges: With the exception of Medical Card holders, and children with long-term ailments or referred from school health examinations, the following charges must be paid in major public hospitals:
  • Casualty and Outpatients pay €100 unless referred by your doctor or admitted to hospital.
  • Public patients pay €80 per night (up to a max €800 in a year).
  • Private patients pay charges even if they are in public wards. The charges are €329-€407 (day care) and €659-€813
    per night (in ward), €800-€1,000 (single room).
  • Refund for Treatment Abroad: The HSE will refund the cost of treatment in another EU country, provided your
    consultant applies in advance, confirms that the treatment is justifiable and is not available in sufficient time in
    Ireland.  Some travel expenses are also covered (Tel: 056 7784059 or email: [email protected]).

NURSING HOME SUPPORT

  • Nursing Home Support: Under the “Fair Deal” patients seeking longterm residential care in either a Private or a Public Nursing Home now have the same Care Needs Assessment and the same means-test for payment. The patient will be liable to pay towards the cost of care:
  • 80% of assessable income (i.e. after deduction of tax, PRSI, mortgage/rent and out-of-pocket medical expenses)
  • plus 7.5% of the value of any assets (net of borrowings against them). The first €36,000 (single), €72,000 (couple) of assets are disregarded.
  • A spouse is assessed with half of the couple’s joint income and assets. The HSE can assess assets transferred in the past 5 years. The balance of the cost will be met by the State.
  • If the assets are in property, the contribution can be deferred until settlement of the person’s estate, but the money owing will be increased by the Consumer Price Index each year. In the case of the family home and of the assets of a family business where a family successor continues to run it for at least six years, the contribution will only be paid for a maximum of three years and so capped at 22.5% of its value (or 11.25%, if covering one spouse). The deferred charge against the home will not be collected during the lifetime of a surviving spouse or a disabled child. This deferral must be separately requested by the patient, or by a care representative approved by the Circuit Court for a patient who is not capable of making the decision themselves.

HOME CARE PACKAGES

  • Home Care Packages are available when more than standard home help is needed to support a family after a patient’s discharge from hospital, or to keep a person out of institutional care. Eligibility is based on a Care Needs Assessment by your Public Health Nurse and is not based on a means-test or holding a Medical Card. There is no charge or contribution to be paid for either short or long-term Care Plans. A Homecare Support Scheme for people who want to remain independent in their own homes is now being developed, but won’t be in place in 2019.

CARERS ALLOWANCE

  • Carers Allowance: A person who is living with (or close by with a direct communication system) and giving full-time care to a child on Domiciliary Care Allowance, or to any person aged 16 or over requiring full-time care, can apply for a  means-tested weekly Carer’s Allowance of 219 (257 if carer is 66 or over) plus an annual €1,700 Carer’s Support Grant.
  • In the means-test, any weekly income of the carer in excess of €332.50 (single), or half of their own and their spouse’s income in excess of €665 (married) is assessed. The allowance is reduced accordingly. Half rate Carer’s Allowance is  payable to persons receiving another Social Welfare payment. Those on Carer’s Allowance are entitled to a GP Visit Card.
  • An additional 50% allowance and full Carer’s Support grant will be paid to a person caring for more than one incapacitated person. Carers are entitled to free travel in their own right. A carer can take up training or paid employment for up to 15 hours per week. Carers Allowance is paid for 12 weeks after the death of the person cared for or their admission to a Long-Stay Nursing Home. Carers are entitled to credited contributions to keep them in benefit. When they cease caring, a carer is entitled to go on Back to Work, Back to Education or Community Employment Schemes.
  • Persons caring full time can qualify for e1,700 Carer’s Support Grant regardless of means, but persons working over 15 hours or on Jobseeker payments will not qualify.
  • A Carer’s Benefit of 220 based on your Social Insurance contribution can be claimed for short-term absences from work (up to 24 months) for caring responsibilities. It is available to all insurance classes except S and J. Limited work earning up to €332.50 per week is permissible, while claiming this benefit. Your job is protected for the 24-month duration. Those on Carer’s Benefit are entitled to a GP Visit Card.