Q+A: Your Guide to Medical Cards

What is a Medical Card?
What Health Services are available Free of Charge if I have a Medical Card?
Am I Entitled to a Medical Card?
To Qualify for a Medical Card - by means test, hardship, or EU entitlement
Can I retain my card if I return to work?
How Long Does the Medical Card Last?
When Can I Apply?
How do I Apply?
What happens if I move to another HSE Local Health Office Area?
What happends when my child turns 16?
Can I Use my Medical Card on Holiday?
What If I Am Not Eligible for a Medical Card?
New Over 70’s Medical Card Review Process

What is a Medical Card?
A Medical Card is a plastic card, about the size of a credit card, issued by the HSE. People who hold a Medical Card are entitled to a range of Health Services free of charge.

What Health Services are available Free of Charge if I have a Medical Card?
You are entitled to the following services if you have a Medical Card:

Doctor Visits - a range of family doctor or GP services from a chosen doctor contracted to the HSE in your local area
Prescription Medicines: The supply of prescribed approved medicines, aids and appliances like wheelchairs, crutches etc. In some circumstances a deposit may be required for aids and appliances which will be refunded on return of the aid or appliance
Certain Dental, Ophthalmic (Eye), and Aural (Ear) health services
Hospital Care - all in-patient services in public wards in public hospitals, including public consultant services
Hospital Visits - All out-patient services in public hospitals, including public consultant services
Maternity Cash Grant on the birth of each child
Medical & Midwifery Care for Mothers, including health care related to pregnancy and the care of the child for six weeks after birth
Some personal and social care services, for example, public health nursing, social work services and other community care services based on client need

You MAY also be entitled to the following additional benefits if you have a Medical Card:

No need to pay the health portion of your social insurance (PRSI)
Free transport to school for children who live 3 miles or more from the nearest school
Exemption from state examination fees in public second-level schools
Financial help with buying school books. The benefits above are available from the relevant government department

Am I Entitled to a Medical Card?
Anyone over the age of 16 years who is ordinarily resident in the State is entitled to apply for a Medical Card. Ordinarily resident means you are living here for a minimum of one year or you intend to live here for a minimum of one year. You can qualify for a Medical Card under the following three main categories:

Means Test: Single People or Families who have an income that is within certain financial guidelines. You can read more about the Medical Card/GP Visit Card Income Guidelines below.
Undue Hardship: People whose income is over the financial guidelines, but the HSE decides that the financial burden of medical or other exceptional circumstances would cause undue hardship
Automatic: People who are automatically entitled to a Medical Card are:
Those with European Union entitlement
Those who are entitled to retain their Medical Card under government schemes
Read more about Medical Cards for Over 70s here.

To Qualify for a Medical Card by Means Testing
If your only income is a means tested Social Welfare Allowance, you will qualify for a Medical Card. You will also get a Medical Card if the income or means of you and your spouse/partner is below our income guidelines. Your means includes any income, property (but not your own home), investments and savings.

When we make an assessment for a Medical Card, we only assess you and your spouse's or partner's income after Tax and PRSI are deducted. We also make allowances for rent and mortgage payments, for childcare expenses, and travel to work expenses. Income or possible income from property is taken into account less any necessary associated costs.

You can read the current HSE Medical Card and GP Visit Card Guidelines here.

To Qualify for a Medical Card on the Grounds of Hardship
If your income is above the HSE income guidelines for your circumstances, you may still be entitled to a Medical Card on the grounds that paying for your medical costs causes you undue financial hardship. Such an example would be if you had an ongoing medical condition that required exceptional and regular medical treatment, or visits to the doctor or hospital.

If the cost of this would cause you undue financial hardship, then you may get a card on these grounds. The HSE always considers other exceptional circumstances where a person or family has personal or social issues causing undue financial hardship. The card may be granted for the whole family, or for individual members of a family on the grounds of undue financial hardship.

To Qualify for a Medical Card by Automatic Entitlement
Certain people who are ordinarily resident in Ireland automatically qualify for a Medical Card. They still need to complete an application form, but they don't need to meet the criteria of the means test. You automatically qualify for a Medical Card if you are among the following groups:

You have EU entitlement
You are entitled under Government Schemes

If You Are Aged 70 years or over
From January 1 2009, the automatic entitlement to a Medical Card on reaching 70 years ended. You can read more about Medical Cards for Over 70s here.

If You Have EU Entitlement
If you belong to one of the following groups, you will get a Medical Card under EU Regulations:

You are living in Ireland and receiving a social security payment from another European Union /European Economic Area (EU/EEA) country or Switzerland and you are not getting an Irish social welfare payment
(apart from Child Benefit or Early Childcare Supplement). You must not be liable to contribute to the Irish Social Welfare System, (i.e. PRSI)
You are living in Ireland and working in another EU/EEA country or Switzerland and are liable to pay Social Insurance Contributions in that country
You are living in Ireland and you are the dependent spouse or child of someone employed in another EU/EEA country and Switzerland. You must not be getting an Irish Social Welfare Payment apart from Child Benefit or Early Childcare Supplement and you must not be liable to contribute to the Irish social welfare system.

The following countries are currently members of the EU:
Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxemburg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, United Kingdom (including Gibraltar).
Countries in the EEA are Iceland, Liechtenstein and Norway.

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Can I retain my card if I return to work?
The retention of Medical Cards (without a means test) is approved for people as indicated below:-

People who participate on certain Government Employment and Education Schemes will retain their entitlement to a Medical Card for the duration of the scheme (Examples include Back to Work Allowance, Community Employment Schemes, Back to Education Allowance, etc.)
People who have been unemployed or in receipt of One Parent Family Payment for a minimum of 12 months will retain their Medical Card for a period of 3 years if they commence employment
When a person who has been unemployed for a period of 12 months or more enters part-time employment, their medical card will be retained for a period of 3 years from the date their income increases to a level which exceeds the appropriate Medical Card Guideline
People who hold a medical card and are in receipt of a Disability Allowance or a Blind Pension from the Department of Social and Family Affairs and who take up employment are allowed to retain their Medical Card for a maximum of 3 years from the date of taking up employment. Dependent members of the family of those covered
by the 'retention' provisions will also be granted medical cards.

How Long Does the Medical Card Last?
The card is usually issued for one year after which it is reviewed. Depending on your circumstances it may be issued for a longer period. 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 medical card section at your Local Health Office as soon as possible.

In any case, usually once a year, the HSE will ask you to confirm your circumstances. A review form is sent to you, which you must fill in and return to your Local Health Office. If you do not return your review form your application cannot be re-assessed and your card may not be re-issued.

When Can I Apply?
You can apply for a Medical Card at any time; you don't need to wait until a medical need arises.

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How do I Apply?
Application forms for a Medical Card / GP Visit Card are available from your Local Health Centre, your Local Health Office or on this site. Each form has a help sheet attached, which will help answer any questions about how to make your application. Fill in each section that applies to you. If you have any problem filling in the form, call to your Local Health Office and we will be happy to guide you.

People who are within the income guidelines can also make an application, or check their eligibility online, at www.medicalcard.ie

You must have a Personal Public Service Number (PPSN) in order to apply. PPS Numbers were previously known as RSI numbers. Information regarding your PPSN is available from your local Department of Social protection office.

You will need a separate application form for each child aged 16 years or over.

There is a section of the form that has to be signed by your doctor.

If you are applying for a Medical Card on the basis of EU entitlement a means test criteria will not apply. However, you will be required to show evidence that you are not liable to pay social insurance (PRSI) in Ireland. See section 'If you have EU Entitlement' for further details.

If you lose or misplace your Medical Card, contact your HSE Local Health Office for more information.

Filling in the Form Properly
The checklist below will help you to fill in the form properly:

Please check that you have completed the following:

Have you provided your own PPSN (Personal Public Service Number) and PPSNs for your spouse and all your dependents?
Have you filled in all the sections that apply to yourself and your family?
If you are employed, have you attached a recent payslip showing your earnings and a P60 form?
If you are self-employed, have you attached a recent income assessment notice from the Inspector of Taxes or a set of recent trading accounts?
Have you signed and dated the form?
Has your doctor signed the form?

Failure to fill out all sections fully may result in delays.

If your application is successful, you will receive a card for yourself and one for each eligible member of your family included on the form. Dependents such as students over 16 and under 25 years must apply separately. Keep your card safe as you need it each time you use any of the services e.g. visit the doctor or chemist.

What happens if I move to another HSE Local Health Office Area?
If you move from one Local Health Office area to another 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 of residence.

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What Happens when a Child Turns 16?
Young people aged 16 years to 25 years, who are financially dependent on their parents, each get their own card when they apply, if their parents are eligible for a Medical Card. If you are not dependent on your parents, your own means and income is considered for assessment. Students can apply for the card, either to the Local Health Office where they attend college or where their parents live.

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Can I Use my Medical Card on Holiday?
You can use your Medical Card for up to three months if you are living temporarily in a different area in Ireland e.g. on holiday. In this case, you can attend any GP in the area participating in the Medical Card scheme. Contact the HSE office in the area you will be visiting for a list of doctors who provide services under the scheme.

If you are going to be away longer than three 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.

You cannot use your Medical Card outside of Ireland. If you are going abroad on a short stay (e.g. on holiday), to a EU/EEA country (excluding the UK) or Switzerland you should obtain a European Health Insurance Card (previously known as an E111 form). Application forms are available from your Local Health Office or online from the EHIC section of this website. European Health Insurance Cards entitle you to urgent healthcare when travelling in the EU.

Irish and UK nationals travelling in the Common Travel Area (i.e., between Ireland or the UK) are not obliged to carry a European Health Insurance Card. In order to obtain necessary healthcare in either country, Irish or UK nationals simply provide evidence of residence in either country, such as driver's licence, passport etc.

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What If I Am Not Eligible for a Medical Card?
You will receive a decision on your completed application within a short time of applying. If you are not satisfied with the decision, you may have it reviewed at your Local Health Office. Your circumstances may have changed or you may have left out some relevant information from the original application. If following this you are still not satisfied - you may appeal to the Appeals Office of your HSE Area. (The contact details will be contained in your letter of refusal). The Appeals Office will conduct a reassessment of your application. This will be conducted by HSE staff not involved in deciding on your original application.

If you are not entitled to a Medical Card you will automatically be assessed for a GP Visit Card. If you are not entitled to a Medical Card or a GP Visit Card there are other HSE schemes that you can apply for. You may find these schemes can ease the financial cost of providing medical care for yourself and your family.

These schemes are as follows:

Drugs Payment Scheme

Long-Term Illness Scheme

Click on the links to get more information on those schemes.

New Over 70’s Medical Card Review Process
A new Over 70’s Medical Card review process is being introduced this week in the Central Office in Finglas (PCRS). A simplified declaration process is replacing the more onerous review application form for medical card holders aged 70 years and over that come up for review by the Central Office.

The new declaration comprises a single page form that can be completed with a single entry, signed and dated, in the event that the circumstances of the medical card holder and his/her dependants have not materially changed since their last review, or their initial application if this is their first review.

This is recognising the fact that the financial circumstances of most medical card holder aged 70 years or over are unlikely to change significantly. The vast majority of such clients continue to hold eligibility on review.

A copy of the letter and new single page form for Over 70 reviews are attached for your information. Please note that pages two and three are printed back to back (i.e. on a single sheet), with the back page for information purposes, and to allow the applicant to correct any error showing in their personal details.

How does the new Over 70 Review Process work?
Three months in advance of the review date for an Over 70 client the Central Office will send out the attached letter and single page declaration/consent form.

If we have not heard back from the client in four weeks a reminder letter will issue.

If the client is satisfied that his/her financial circumstances have not changed to the extent that s/he may no longer be entitled to a Medical Card s/he simply reads the declaration and consent, signs and dates it, puts in their telephone number and returns it to us at the address provided.

If the client thinks that his/her financial circumstances have changed to the extent that s/he may no longer be entitled to a Medical Card, and s/he wishes to apply for a full review in order to determine if s/he still falls within the financial guidelines under the new scheme, s/he can complete a normal Over 70’s review form and submit it in the normal way. If they know that they are over the Gross income limits set out under the new scheme, they can also still apply under the main scheme to retain their medical card on discretionary grounds, in the normal way.

Are the assessment/review rules or requirements any different to the national assessment guidelines?
No, this new process simply recognises the fact that the financial circumstances of clients aged 70 years and over do not, in the vast majority of cases, change significantly, and also takes cognisance of the worry and upset that formalities and form filling can cause to some vulnerable clients in this cohort.

Last updated on: 28 / 07 / 2010

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