Health services for visitors to Ireland

Rules

Your entitlement to health services is mainly based on residency and means, rather than on your payment of tax or pay-related social insurance (PRSI). Broadly speaking, if you are living here and intend to continue to live here for at least a year, you will be considered to be "ordinarily resident". This applies regardless of your nationality and anyone who is accepted by the Health Service Executive (HSE) as being "ordinarily resident in Ireland" is entitled to either full eligibility (i.e., to hold a medical card) or limited eligibility for health services. There are, however, some exceptions to this and these are described below.

Your nationality, in itself, does not determine your entitlement but there are specific rules covering EU/EEA nationals and Swiss nationals.

The Department of Health has issued guidelines to Local Health Offices about how they should decide on whether or not a person is ordinarily resident. The HSE retain the discretion to provide health services to any person in cases of hardship.

Nationals of other EU/EEA countries or Switzerland

If you have previously lived and worked in another EU/EEA member state or Switzerland, you may have an entitlement under EU rules as a result of residence or employment in an EU country.

• Pensioners

If you have a social security pension from an EU/EEA member state or Switzerland but do not have an Irish social welfare pension (either as a recipient or as a dependant) and you are not employed or self-employed in Ireland, you may be entitled to a medical card on production of EU Form E121.

• Unemployed people

If you have transferred your Unemployment Benefit from another EU/EEA country or Switzerland to Ireland and are looking for work here, you may be entitled to a medical card. Form E119 is issued by your home country and you can receive a medical card in Ireland for the duration of the time specified on your E119 form.

Dependants of pensioners or unemployed people also receive medical cards, provided that they (or in the case of children) the spouse or person looking after them are not employed or self employed in Ireland.

• Posted Workers

If you are sent by your employer to work in Ireland on a short-term basis (less than 12 months), you are entitled to receive necessary health services free of charge. You should have a European Health Insurance Card, provided your posting is expected to be for less than 12 months and does not involve replacing someone else on a similar assignment. Where your assignment in Ireland is for a longer duration or involves the replacement of another person, EU regulations do not apply and you should be regarded as being "ordinarily resident" in Ireland. If you have come from Great Britain, you will not require a European Health Insurance Card to receive urgent health services free of charge but you will be required to show proof of your UK residence.

• Students

If you are a student from another EU country, you may receive necessary treatment free of charge if you are covered by a European Health Insurance Card or produce evidence of UK residence. If your academic course is of at least one year's duration, you may apply for eligibility under the health system in Ireland and would be considered as "ordinarily resident".

If you are not ordinarily resident, you may be entitled to avail of public health services in the following circumstances:

Urgent health services

Urgent health services mean:

• urgent medical treatment for sickness or pregnancy by a general practitioner or specialist
• prescribed drugs and medicines
• dental treatment (for relief of pain only)
• hospital services

They do not mean:

• non-urgent or elective treatment that can reasonably be postponed until you return to your own country
• any case in which a person travels to Ireland for the specific purpose of obtaining treatment.

Nationals of non-EC or non-EEA countries (except Switzerland)

In general, if you are a national of a non-EU or non-EEA country (with the exception of Switzerland), you are regarded as ordinarily resident in Ireland if you can show the Health Service Executive (HSE) that you intend to live here for at least a year. The HSE may look for evidence that you are legally entitled to live here for at least a year. Here are some examples of this evidence:

• A work permit or visa, a statement from your employer or a contract of employment
• Evidence of transfer of funds, bank accounts, pensions
• Proof of purchase of a property or property rental (i.e., a lease), including evidence that the property in question is your main residence
• A GNIB (Garda National Immigration Bureau) residence permission as stamped on your passport.

If you are a dependant of a non-EU/non-EEA/non-Swiss national, the same rules about ordinary residence apply to you. In other words, the fact that a non-EU/non-EEA/non-Swiss national has established his or her eligibility for health services here does not mean that non-resident dependants are also entitled to health services in Ireland.

Students from non-EU or non-EEA countries (except Switzerland)

If you are a student from a non-EU or non-EEA country (with the exception of Switzerland), you are generally regarded as ordinarily resident if you are registered for a course of study that will last for at least one academic year.

If you are here for a shorter period, you are regarded as a visitor and you do not have any entitlement to free or subsidised health services.

Asylum seekers and refugees

Asylum seekers are given medical cards for the period during which their application for refugee status is being considered. If you get refugee status, then you are regarded as ordinarily resident and you come under the usual rules for entitlement to health services.

Irish nationals who have been living outside Ireland

If you come back to live in Ireland and are working or self-employed here or if you intend to stay for a year, then you are ordinarily resident and come under the usual rules.

If you are not in this situation and you have been living and working in another EU/EEA country or Switzerland, your entitlement to health services when you return is decided under the rules applying to EU nationals.

If you have been abroad on a short-term contract, you continue to be regarded as ordinarily resident.

If you have been resident abroad for a period of up to three years but your Local Health Office of the HSE is satisfied that you did not establish an entitlement to health services in any other country, the HSE should regard you as ordinarily resident in Ireland if you require treatment when you return to Ireland. This factor is important in that it ensures that people who emigrate from Ireland do not lose their health service eligibility on residence grounds before they have a chance to establish eligibility elsewhere. This provision does not apply where someone is covered by EU regulations in another country and, in particular, it would not entitle a person temporarily resident in another EU country to have the HSE extend the European Health Insurance Card beyond the normal period.

People who are not entitled to free health services

If you are not ordinarily resident and you do not come under any of the headings described above, the HSE may either apply the full economic cost for any services provided or provide urgent necessary treatment at a reduced charge or without charge in cases of hardship.