Medical Card

A medical card issued by the Health Service Executive (HSE) allows the holder to receive certain health services free of charge. 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 - see general income guidelines below. Normally, your dependent spouse or partner and your children are also covered for the same range of health services. Medical cards are small plastic cards (similar in size to a credit card). Your medical card will show your doctor's name. It is usually issued for a year, after which it is reviewed.  Medical card holders pay the Universal Social Charge on their income (except for social welfare and HSE payments), but at a maximum rate of 4%. The only exemption is for people earning less than €4,004 per annum. They may also be exempt from paying school transport charges, State exam fees in publicly-funded second-level schools. There may also be financial help with buying school books in certain schools.

GP Visit Cards
Unless you have a medical card, visits to GPs (family doctors) are not free. If you do not qualify for a medical card on income grounds, you may qualify for a GP Visit Card. It is means tested, but the income limits are 50% higher than for the medical card.

What health services are normally covered?
If you have a medical card, you are entitled to:

If you move house
You can use your medical card for up to 3 months if you are living temporarily outside your Local Health Office 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 should apply to the Local Health Office of that area, for a medical card. If you move to a different part of your own Local Health Office area, you can apply to change your doctor.

Other eligible categories of people
You may get a medical card in certain situations without a means test, for example under EU Regulations. Medical cards are usually granted to children in foster care. Full-time students aged 16-25 who are financially independent of their parents may be entitled to a medical card. If you are receiving a social welfare payment and return to work, you may retain your medical card for up to 3 years. There is more detail about these situations in 'further information' below.

Prescription charges for medical card holders
From 1 October 2010 medical card holders pay 50 cent charge per prescription item, subject to a monthly ceiling of €10 per family.  The charges do not apply to children in the care of the HSE who have their own medical card. This includes children in residential care, foster care, foster care with relatives and other care placements.

General income guidelines
Normally, your total income is taken into account in the means test for the medical card. There are different guidelines for those aged under 70 years and those aged over 70 years. Any cash, savings, investments or property (except your own home) is also taken into account. However, there are certain exceptions. According to the HSE's guidelines, if your income is derived solely from Social Welfare allowances or benefits or HSE allowances you should be granted a medical card even though your payment is in excess of the Income Guidelines for your age and situation. The assessment of a couple for medical card purposes is based on the age of the older person.
Income not taken into account when assessing income for medical card purposes
Certain compensation awards

            Repayments made under the Health (Repayment) Scheme (that is, the Nursing      
Home repayment scheme)  

Certain payments made by the State

Under 70s: Guidelines on income and capital
Lone parents with dependants are assessed under the income limits for couples.
Weekly income limit (gross, less tax, Universal Social Charge and PRSI)


Category

Aged under 66

Aged 66-69

Single person living alone

€184

€201.50

Single person living with family

€164

€173.50

Married or cohabiting couple (or lone parent with dependent children)

€266.50

€298

Allowance for each of first 2 children aged under 16

€38

€38

Allowance for 3rd and each subsequent child under 16

€41

€41

Allowance for each of first 2 children aged aged over 16 (with no income)

€39

€39

Allowance for 3rd and each subsequent child over 16 (no income)

€42.50

€42.50

Each dependant over 16 years in full-time third-level education, who is not grant aided

€78

€65


Reasonable expenses incurred in respect of childcare costs and rent/mortgage payments will also be allowed. (There is, however, no exact definition of what 'reasonable expenses' actually means in relation to housing or childcare costs).

 

Weekly travel costs to work
The actual cost of public transport is allowable or, for car owners, mileage at 30 cent per mile/18 cent per km plus a weekly amount of €50 to cover standing charges (depreciation and running costs). Where a couple needs two cars to travel to work a double allowance applies.
How capital is assessed for the under 70s
All capital (savings and investments) is taken into account for medical card purposes. However, income on the savings/investments or property of €36,000 for a single person and €72,000 for a couple is disregarded.
The disregard figure only applies once where both savings and property (other than your own home) are being assessed.
The balance is taken into account either by taking into account the actual rate of interest received, if you provide a certificate of the interest paid on in the last full calendar year or by using a notional rate. The HSE will use whichever calculation is better for the applicant.
In essence, only the interest or income earned on savings and similar investments will be counted as income, not the total value of the savings or investments themselves.
Notional assessment of interest


Capital

Weekly means assessed

First €36,000 (single), €72,000 (couple)

Nil

Next €10,000

€1 per €1,000

Next €10,000

€2 per €1,000

Balance

€4 per €1,000


In the case of fixed-term or long-term savings products, where the interest is only applied at the end of a fixed period, if you wish, the HSE will only take account of the interest earned on the date the investment matures. The calculation of interest includes Deposit Interest Retention Tax. Again, the HSE can apply the notional rate if the applicant wishes.
Property (other than family home)
Where land/buildings are leased to another person, the income to be assessed will be the gross income, less any cost necessarily incurred associated with the property and such cost may include insurance premiums, loan/mortgage repayments, maintenance etc.
Where land/buildings, which are not being used but are capable of being leased or sold then the following assessment options can be used, with the more beneficial option applying to the applicant:
Notional assessment of the rental/lease “going rate” for the area.
Assessment of capital value as in the table for capital, above.

How to apply
You can get the application form and a list of participating GPs from your local health centre or Local Health Office for your area. You can also apply online for a medical card on www.medicalcard.ie. Alternatively, you may download a medical card application form MC1 from www.hse.ie. You complete it and bring it to the GP you have chosen from the list of participating doctors. The GP you select must generally have his/her practice within 7 miles of where you live. The GP must agree to accept you as a patient. If the GP accepts you as a patient, he/she signs the form. Your employer also has to sign the form and certify your earnings or if you are claiming a social welfare payment, the form has to be stamped at the Social Welfare Local Office. Self-employed people have to submit their most recent tax assessment form or set of trading accounts. If you are aged under 70, the application form should be returned to the Local Health Office. You can track the progress of your medical card application at www.medicalcard.ie.

GP Visit Card: If you are under age 70 and your income is above the guidelines you will automatically be assessed for the GP Visit Card. If you are over 70 years old, and your income is above the guidelines for the over 70s you can be assessed for the general medical card and GP Visit Card. You can also apply for the Drugs Payment Scheme at any age.

Appeals
If you have been refused a medical card and 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 make an appeal to the Appeals Office of your HSE Area. 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 not involved in deciding on your original application. Contact your local health centre or Local Health Office if you have any questions about medical cards and eligibility. You can also contact the HSE Infoline: Callsave 1850 24 1850
HSE Primary Care Reimbursement Service Exit 5 M50
North Road
Finglas
Dublin 11
Ireland
Tel: 01 864 7100