• Primary Medical Cover: A Medical Card entitles you to all 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 of regular weekly out of pocket medical expenses. Savings are valued in the same way as for non-contributory OAP. The cards will be granted if your remaining income after these deductions does not exceed the following guideline for 2012:
Medical Card GP Only
Under 66 66 and over Under 66 66 and over
• Single living alone €184.00 €201.50 €276.00 €302.00
• Single living with family €164.00 €173.50 €246.00 €260.00
• Married couple (or single parent) €266.50 €298.00 €400.00 €447.00
Additional Allowance for Dependent Children: Medical Card GP Only
• for first two children under 16 €38.00 €57.00
• for other children under 16 €41.00 €61.50
• for first two children over 16 €39.00 €58.50
• for other children over 16 €42.50 €64.00
• for over 16 in full time third level (no grant) €78.00 €117.00
Persons on Social welfare who have no other income will generally qualify for a medical card. An increase in Social Welfare will not cause you to lose your card. Free GP service will be given to a person with a Long Term Illness Card during 2012. The HSE will consider cases outside these guidelines in special circumstances, for example to cover one family member with high medical costs. Medical Card holders do not have to pay exam fees for children. 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 €204.30 but under the above guidelines.
• Persons aged 70+ qualify for a Medical Card if your gross weekly income is less than €700 per week (single), or €1,400 (married).
• Once either spouse qualifies at 70, both get cover.
• A surviving partner aged over 70 will be allowed to keep their medical card for three years.
• In the means test, the first €36,000 (single), €72,000 (couple) of assets are disregarded. On the balance only the income actually earned will be counted.
• A €0.50 charge per prescription item applies to medical card holders (max €10 per month per family). It does not apply to those on the long-term illness scheme.
• Drug Refund: Any family can get a refund on the cost of prescribed drugs used in any month in excess of €132
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.
• 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 Outpatient €100 unless referred by your doctor or admitted to hospital
• Public Ward Bed €75 per night (up to a max. €750 in a year)
• Private patients pay €1,118 per night (semi-private), €1,243 (private), €916 (day care).
During 2012, the distinction between public and private beds will be ended, so all private patients will be charged these private bed rates.
• Nursing Home Support: Under the “Fair Deal” patients seeking a place in either a Private or a Public Nursing Home now have the same assessment of need 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 5% of the value of any assets, in excess of a disregard of €36,000
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 only, the deferred contribution will be capped at 15% (i.e. after three years of care). The deferred charge against the home will not be collected during the life time 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 PACKAGE: A Home Care Package can fund a care plan in the home, where the need is assessed on discharge from hospital, or by the Public Health Nurse to keep a person out of institutional care. The HSE will fund the cost where the patient’s income is no more than e100 in excess of the Contributory Old Age Pension. The HSE contribution is reduced by income in excess of that limit.
• 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 Carers Allowance of €204 (€239 if carer is 66 or over) plus an annual €1,700 Respite 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, disregarding the first €7.60. Half rate Carers Allowance is payable to persons receiving another Social Welfare Payment.
An additional 50% allowance and full respite 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 are entitled to credited contributions to keep you in benefit. When you cease caring, you are entitled to go on Back to Work, Back to Education or Community Employment Schemes.
• Persons caring full time can qualify for €1,700 Respite Grant regardless of means but persons working over 15 hours or on Jobseeker payments will not qualify.
• A Carers Benefit of €205 based on your Social Insurance 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.
• A Mobility Allowance of €208.50 per month is payable by the HSE to a person (aged 16-66) who is unable to walk, if their income does not exceed Social Welfare Contributory Pension by more than €12.70 per week.