As part of an ongoing information process about benefits and entitlements, this week I am sharing details about medical cards. I am indebted to Ciizens Information for the following:
If you have a medical card issued by the Health Service Executive (HSE), you can receive certain health services free of charge. Normally, your dependent spouse or partner and your children are also covered for the same range of health services.
To qualify for a medical card, your weekly income must be below a certain figure for your family size. Cash income, savings, investments and property (except for your own home) are taken into account in the means test.
GP visit cards: If you do not qualify for a medical card on income grounds, you may qualify for a GP visit card.
What health services are normally covered?
If you have a medical card, you are entitled to:
Free GP (family doctor) services, including out-of-hours services
Prescribed drugs and medicines — some prescription charges apply
In-patient public hospital services, out-patient services and medical appliances
Dental, optical and aural services
Maternity and infant care services
Some personal and social care services, for example, public health nursing, social work services and other community care services
Short-term counselling for mild to moderate psychological difficulties, using the Counselling in Primary Care Service
A maternity cash grant of €10.16 on the birth of each child (apply to your Local Health Office)
Other benefits
Medical card holders pay the Universal Social Charge on their income if it is over the exemption limit, but there is a reduced rate. Medical card holders may also be exempt from paying school transport charges and State exam fees in publicly-funded second-level schools. There may also be financial help with buying school books in certain schools.
Rules
Means test
Normally, your total income is taken into account in the means test for the medical card.
There are different guidelines for the means test depending on your age:
Means test rules for people under 70 years of age
Online link: https://www.citizensinformation.ie/en/health/medical_cards_and_gp_visit_cards/medical_card_means_test_under_70s.html
Means test rules for people over 70 years of age
Online link:
https://www.citizensinformation.ie/en/health/medical_cards_and_gp_visit_cards/medical_card_means_test_over_70s.html
The assessment of a couple for medical card purposes is based on the age of the older person.
If your income is above the limit, you may still be able to obtain a medical card if your circumstances would result in hardship without one. This is sometimes called a discretionary medical card. See the Assessment Guidelines in Further information below for details.
People aged 16–25, including students
If you are aged 16–25 and dependent on a parent or guardian, you are eligible for a medical card if your parent or guardian has a medical card. (This does not apply if their income is above the means test limit and they have a discretionary medical card.)
If you have an income over the medical card income limit for a single person living with family, you are considered financially independent and in this case the usual means test applies.
If you are not living with or dependent on a parent or guardian, then you are living as an independent person regardless of income and your application is assessed using the standard means test.
Domiciliary Care Allowance
If you have a child for whom you are getting Domiciliary Care Allowance, the child is eligible for a medical card, without a means test, from 1 June 2017.
If the child does not have a medical card or GP visit card, you can register the child for a medical card online at this link:
https://www.sspcrs.ie/portal/free-gp-care-dca-web/pub/home
or download a registration form at this link:
https://www2.hse.ie/file-library/medical-cards/domiciliary-care-allowance-medical-card-registration-form.pdf
If the child already has a medical card or GP visit card, you do not need to register; they will be automatically registered for a medical card.
People who may qualify without a means test
Those with EU (European Union) entitlement — see ‘Further information’ below
Children under 18 years of age who have been diagnosed with cancer within the last 5 years
People affected by the drug Thalidomide
Women who have had a symphysiotomy
People who live in direct provision accommodation
Children in foster care
Women who were resident in certain institutions
After your card is issued
If your circumstances change you must inform the HSE as you may no longer be eligible. For example, if your income or family circumstances change, you must inform the Client Registration Unit as soon as possible — see ‘How to apply’ below. Your card will be reviewed periodically.
Reviews
The HSE will ask you periodically to confirm your circumstances by completing an online review form. If you do not provide the requested information, your application cannot be re-assessed and your card may not be re-issued.
If you require a paper form, rather than the online review form, complete and return MC1 Medical Card and GP Visit Card Application Form. For online, click on the link:
https://www2.hse.ie/file-library/medical-cards/medical-card-application-form-english.pdf
If you are aged over 70, the review notice you receive will include a form that you can use as an alternative to the online review form.
If you complete the review form by the given date but the review process continues past the expiry date of your card, the card’s validity may be extended so that you can continue to use it while the review is taking place. The extension is on a month-by-month basis so it is advisable to contact the Client Registration Unit to confirm that your card has been extended and continues to be valid.
Returning to work
If you are getting a social welfare payment for a year or more and return to work, you may be able to keep your medical card for up to 3 years. You will need to submit a new medical card application stating that you are applying on this basis. Dependent family members may qualify to keep their card, even if they become employed during this 3 year period.
People taking part in certain government schemes may keep their medical cards while they are on the scheme. See the assessment guidelines (pdf) for the list of schemes at the following link:
https://www2.hse.ie/file-library/medical-cards/medical-cards-national-assessment-guidelines.pdf
If you move
You can use your medical card for up to 3 months if you are living temporarily in a different area. In this case, you can attend any GP in the area participating in the medical card scheme. If you are going to be away longer than 3 months, you do not have to re-apply for a new Medical Card. You should make contact with your new Local Health Office where you will be advised of the GPs practising in your new area.
If you are changing your GP, you complete a Change of Doctor Form – https://www.sspcrs.ie/portal/medapp/changedoctor.pdf –
giving details of the new doctor. The form is available online or by phoning Lo-call 1890 252 919.
How to apply
If you have any questions before you send your application, you can phone Lo-call 1890 252 919, contact your Local Health Office, or email [email protected].
You can apply online for a medical card on medicalcard.ie. This is the quickest method of obtaining the card.
Alternatively, you can download a medical card application form:
MC1 Medical Card and GP Visit Card Application Form
https://www2.hse.ie/file-library/medical-cards/medical-card-application-form-english.pdf
MC1(a) Medical Card and GP Visit Card Application Form
People Aged 70 Years or Older
https://www2.hse.ie/file-library/medical-cards/over-70s-medical-card-application-form-english.pdf
If you are aged over 70
You can also get the application form and a list of participating GPs from your local health centre or Local Health Office for your area.
You bring the form to the GP you have chosen from the list of participating doctors. Usually, the GP you select must have his/her practice within 7 miles of where you live. If the GP agrees to accept you as a patient for medical card GP services, he/she signs the form. If you are refused by 3 GPs, state this on your application, including details of the doctors, and the HSE will assign a doctor to you.
You return the form to the Client Registration Unit, along with any documents required. If you are applying online you can upload photos, scans or photocopies of the original documents the documentary evidence specified on the form.
You can track the progress of your medical card application at medicalcard.ie.
Adding an infant to your card
If are a medical card holder and you have a baby, you can apply for a card for the infant if you are getting Child Benefit for the child. To apply, send a covering note with your name, address, phone number, PPS Number and medical card details and include a photocopy of the child’s birth certificate and PPS Number. See below for contact details.
Children with Domiciliary Care Allowance
For a child that does not have a medical card or GP visit card, you can register the child for a medical card online
https://www.sspcrs.ie/portal/free-gp-care-dca-web/pub/home
or download a registration form from the HSE website
https://www2.hse.ie/file-library/medical-cards/domiciliary-care-allowance-medical-card-registration-form.pdf
If the child already has a medical card or GP visit card, you do not need to register; they will be automatically registered for a medical card.
Children diagnosed with cancer
Children under the age of 18 who have been diagnosed with cancer within the last 5 years are eligible for a medical card without a means test. The application form does not require information about income but does require a medical report. You can download the Medical Card Application Form for Children under 18 years, Form MC1(b).
https://www2.hse.ie/services/medical-cards/medical-card-for-children-with-cancer.html
Appeals
If you have been refused a medical card and are not satisfied with the decision, you may have it reviewed. Your circumstances may have changed or you may have left out some relevant information from the original application. If you are not satisfied with the review you may make an appeal to the Appeals Office for your HSE Area.
https://www.hse.ie/eng/services/yourhealthservice/appeals/appeals-process/
The contact details will also be contained in your letter of refusal. The Appeals Office will conduct a reassessment of your application. This will be conducted by HSE staff who were not involved in deciding on your original application.
Where to apply
Client Registration Unit
4th Floor
HSE PCRS
Finglas
Dublin 11
Tel: (051) 595 129
Locall: 1890 252 919
Fax: (01) 834 3589
Homepage: http://www.medicalcard.ie
Contact Form: https://www.sspcrs.ie/portal/medapp/contact.jsp
Email: [email protected]
Client Registration Unit (Postal applications)
P.O Box 11745
Finglas
Dublin 11
D11 XKF3
Further information:
The HSE has published assessment guidelines for medical card applications
https://www2.hse.ie/services/medical-cards/medical-card-application-process/how-to-apply-for-a-medical-card.html
Entitlement under EU Regulations
If you are getting a social security pension from another country in the EU, the EEA (European Economic Area) or Switzerland, or if you are working and paying social insurance in one of these countries, you may qualify for a medical card under EU rules if you are ordinarily resident in Ireland.
You must not be subject to Irish social security legislation. This means that you must not be in receipt of a contributory Irish social welfare payment or be working in Ireland and be liable to pay PRSI.
If you are living in Ireland and you are the dependant of a pensioner entitled under EU Regulations, or are the dependant of a person who is working in another country covered by the Regulations, you may be eligible for a medical card. You must not be subject to Irish social security legislation (in the case of child dependants this rule applies to the spouse or person looking after them).
Posted workers and their dependants may qualify for the medical card. These are workers who are employed in another country covered by the Regulations but are sent by their employers to work in Ireland for a limited time.
See the assessment guidelines ( https://www2.hse.ie/file-library/medical-cards/medical-cards-national-assessment-guidelines.pdf ) for more information about entitlement under EU Regulations.
To apply, you submit the medical card application form and include the relevant E or S form. The E or S form is issued in your country and confirms that you are part of a health insurance scheme in another EU/EEA country or Switzerland. If your country confirms that you are entitled to healthcare here you do not need to complete a financial assessment.
If you need further assistance, you can contact the constituency office on 093-26476 or email [email protected]