Hospital Charges

If you need to attend a public hospital or stay overnight in hospital as a public patient, you may be liable for Hospital Charges. Medical card holders and certain other groups do not have to pay hospital charges.

What are Hospital charges?

Everyone living in Ireland and certain visitors to Ireland are entitled to a range of health services either free of charge or at reduced cost. If you need to attend a public hospital or stay overnight in hospital as a public patient, you may be liable for Hospital Charges. Medical card holders and certain other groups do not have to pay hospital charges.

There are several types of hospital charges, which include:

• Out-patient charges
• Emergency Department charges
• Daily in-patient charges
• Long-term stay charges

Inpatient and Day Service Charges

The charge for inpatient/day services is €80 per day up to a maximum of €800 in a rolling 12 month period regardless of how many public hospitals you are admitted to in that period.

You should keep all receipts. This is in case you need to request a refund or cancel an invoice. 

The charge does not apply to the following groups:

• Children Under 16
• Medical card holders
• People receiving treatment for prescribed infectious diseases  - including coronavirus (COVID-19) 
• People who are subject to 'long stay' charges
• 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 maternity services
• People with Hepatitis C who have a Health Amendment Act Card
• People who are part of the Redress Scheme for Women Resident in Certain Institutions

In cases of excessive hardship, a HSE Area may provide the service free of charge.

Outpatient and Emergency Department (A+E) Charges

If you attend the out-patients department or emergency department (A+E) of a public hospital without being referred by your GP or family doctor, you may be charged a standard fee. There is no charge if you are referred by your GP. You must show the referral letter from your GP when you attend the out-patients department or emergency department (A+E). 

Since January 1 2009, this charge is €100.

This charge is not applicable if you are in one of the following groups:

• Medical card holders
• People admitted to hospital after attending the emergency department (you will then be subject to in-patient/day service charges)
• People receiving treatment for prescribed infectious diseases - including coronavirus (COVID-19)
• Children, in respect of the following diseases and disabilities: “mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy”
• People who are entitled to hospital services because of EU Regulations

Note that in select cases where people have difficulty paying, the HSE may provide the service free of charge. You should also note that return visits in relation to each episode of care will not be subject to any additional charge.

If you are referred by your GP to out-patients for specialist assessment by a Consultant or his or her team for diagnostic assessments such as x-rays, laboratory tests or physiotherapy, there is no charge if you attend as a public patient.

If you wish to attend a consultant as a private patient, you will be required to pay the appropriate private fee.

Long-stay patients

Health Regulations came into effect on 14 July 2005 (most recently amended in 2011). These required that charges be imposed on long-stay or extended care patients in HSE public care (not including certain exempted persons such as patients in acute hospitals who require acute care and treatment), up to a maximum of €179 per week.

The Regulations provide for different charging arrangements, depending on the level of care being provided:

Class 1: those receiving in-patient services in premises where nursing care is provided on a 24 hour basis. Maximum weekly charge for the maintenance element of care is €179 (for those whose weekly income is calculated at €223 or higher), reducing progressively in line with assessed weekly income.

Class 2: those receiving in-patient services in premises where nursing care is not provided on a 24 hour basis. Maximum weekly charge is €134 (for those whose weekly income is calculated at €209 or higher), reducing progressively in line with the person's assessed weekly income.

Income-related schedules of Class 1 and Class 2 charges are set out in the Health (Charges for In-Patient Services) (Amendment) Regulations 2011 and are designed to ensure that every Class 1 patient retains a minimum of between €33 and €37.99 of their weekly income for personal use. Every Class 2 patient will retain a minimum of between €64 and €68.99.

In certain circumstances the Health Service Executive has the discretion to alter charges in order to avoid hardship.

Private patients in public or voluntary hospitals

Patients who opt for private in-patient (including day-care) services in public hospitals are liable for a range of private accommodation charges (see table here under) and a charge equivalent to the statutory charge (currently €80 per day up to a maximum of €800 in any 12 month period). There are no exemptions from these charges.

The separate statutory charge of €80.00 does not apply for private patients

As a private patient, you must also pay for the consultant’s services which may include the services of radiation oncologists, anaesthetists, etc.

The hospitals operate a direct payments scheme with Vhi Healthcare, Laya Healthcare, Irish Life Healthcare, ESB Medical Provident Fund, St. Paul's Garda Medical Aid Society and Prison Officers' Medical Aid Society (POMAS).

All insurance forms must be completed on or during admission.

We recommend that patients check with their insurance company before admission to the hospital to ensure they are adequately covered for their treatment.

Road Traffic Accident (RTA) charges imposed under the Health (Amendment) Act, 1986

Patients receiving hospital care following a road traffic accident (RTA) must pay additional charges for their hospital care.

Currently, where a patient becomes subject to RTA charges in circumstances when he/she has previously paid private inpatient charges, the RTA charges levied shall be reduced by the amount of the private in-patient charges already paid in the following circumstances:
(i) private in-patient charges and RTA charges have been levied on a patient, and
(ii) the private in-patient charges and RTA charges relate to the same period of hospitalisation.

By way of illustration, if private in-patient charges in the amount of €2,000 have been paid and RTA charges in the amount of €5,000 have been levied (both in respect of the same period of hospitalisation), the amount of the RTA charges should be €3,000:
(i) €2,000 in respect of private in-patient charges paid; and 
(ii) €3,000 in respect of RTA charges.

The total amount of the combined charges, therefore, is €5,000.