Medical cards
Introduction
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 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 may be issued for up to 3 years, 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 €10,036 per annum. Medical card holders 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:
- Free GP (family doctor) services
- Prescribed drugs and medicines (with some exceptions). See section on prescription charges.
- 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
- A maternity cash grant of €10.16 on the birth of each child.
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.
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 HSE Central Medical Card Office as soon as possible - see 'How to apply' below. Your card will be reviewed periodically - see - 'Reviews' below.
Reviews
In any case, the HSE will ask you periodically to confirm your circumstances. A review form is sent to you, which you must fill in and return to the HSE Central Medical Card Office. If you do not return your review form your application cannot be re-assessed and your card may not be re-issued.
You may continue to use your expired card while a review is taking place, as long as you continue to be involved in the review process. Your eligibility can be confirmed by any doctor or pharmacist or through the GP practice systems, or you can confirm it yourself online at medicalcard.ie.
Prescription charges for medical card holders
Medical card holders pay €1.50 charge per prescription item, subject to a monthly ceiling of €19.50 per family.
Means test
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. The assessment of a couple for medical card purposes is based on the age of the older person.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 HSE issued updated Medical Card/GP Visit Card National Assessment Guidelines (pdf) and Medical Card/GP Visit Card National Assessment Guidelines for people aged 70 years and over (pdf) in April 2013.
Income not taken into account when assessing income for medical card purposes
Certain compensation awards:
- Compensation payments made by the Residential Institutions Redress Board
- Repayments made under the Health (Repayment) Scheme (that is, the Nursing Home repayment scheme)
- Awards made to people who contracted Hepatitis C or HIV from contaminated blood products (together with income from the investment of that money)
- Ex- gratia payments approved by the Lourdes Hospital Redress Board under the terms of the Lourdes Hospital Redress Scheme 2007.
- HSE payments: Foster Care Allowance, Mobility Allowance, Blind Welfare Allowance
- Social welfare payments: Family Income Supplement, Child Benefit, Carer's Allowance, Domiciliary Care Allowance, Guardian's Payments; Fuel, Island, Living Alone and Over 80 Allowances; weekly supplements (such as a diet or heating supplement) paid under the Supplementary Welfare Allowance scheme
- Other payments: Third level educational maintenance grants, Rehabilitation Maintenance Allowance, earnings from employment of a rehabilitative nature (up to €120.00 per week).
People who are exempt from the means test
- Those with EU entitlement: see 'Further information' below.
- People affected by the drug Thalidomide
- Women who had a symphysiotomy
Other eligible categories of people
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.
Income
Under 70s: income
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 | €78 |
Reasonable expenses incurred in respect of childcare costs and rent/mortgage
payments will also be allowed. Since April 2013 home improvement loan payments
are not longer disregarded in the standard medical card means test assessment.
Rent and mortgage payments are not affected.
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. Where a couple needs two cars to travel to work a double allowance applies. The €50 per week from travel-to-work expenses, which was allowed to cover standing charges such as car depreciation, is no longer allowable in the standard medical card means test assessment from April 2013 onwards. Mileage costs are not affected.
However, if your income is over these limits, you can still apply for the medical card on hardship grounds: for example, if you have high medical expenses or your income is only slightly over the limit.
Over 70s: income
Since 5 April 2013 the gross income limit for the over 70s medical card is €600 per week for a single person and €1,200 per week for couples.
The Health (Alteration of Criteria for Eligibility) Act 2013 sets out these limits.
There are no standard deductions allowable (for example, for income tax). Pensions, earnings, interest from capital and all other sources of income are included in the means test - see 'Capital and property'.
The medical card will be replaced with a GP Visit Card if your income is between €600 and €700 (single person) or €1,200 and €1,400 (married or cohabiting couple).
However, if your income is over these limits, you can still apply for the ordinary medical card or GP Visit Card: for example, if you have high medical expenses, such as paying for a nursing home.
Spouse/partner aged under 70 years: Where one spouse is aged over 70 years and the other spouse is aged under 70 years, they will both qualify for a medical card if their income is below €1,200 a week.
Surviving spouse or partner: If your spouse or partner dies after 5 April 2013 and you are aged over 70, you can keep your medical card for 3 years, provided that your income is less than €1,200. After 3 years the relevant income limit for a single person applies.
If you are aged under 70 when your spouse or cohabiting partner dies the relevant income limit for a single person applies.
Capital and property
Under 70s: assessment of capital
All capital (savings and investments) is taken into account for medical card purposes. However, income from savings, investments or property of €36,000 for a single person and €72,000 for a couple is disregarded. after this a 'notional' assessment is applied.
The disregard figure only applies once where both savings and property are being assessed. The value of your family home is not assessed.
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 essence, only the notional income earned on savings and similar investments will be counted as income, not the total value of the savings or investments themselves.
Property (other than the 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.
Over 70s: assessment of capital
Savings or similar investments of €36,000 for a single person and €72,000 for a couple are disregarded. A notional rate of interest is applied by the HSE to the balance.
Alternatively, the HSE will apply the actual rate if you provide a certificate of interest paid on savings in the last full calendar year. 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. Again, the HSE can apply the notional rate if you wish.
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.
Example: a single person who has €50,000 savings, earning 3% interest.
The first €36,000 is disregarded. Only €14,000 is taken into account.
The income is counted as 3% of €14,000, which is €420 a year or €8.05 a week.
Note that any calculation of interest must include Deposit Interest Retention Tax (DIRT).
Property: over 70s only
Income will not be assessed from property (whether a family home, a
holiday home or any other property) unless it is generating a rental
income. The income to be assessed will be the actual income, less any
cost necessarily incurred associated with the rental of the property. Such
costs may include insurance premiums, loan or mortgage repayments, maintenance,
etc.
How and where to apply
If you have any questions before you send your application you can contact Lo-call 1890 252 919 or your Local Health Office or the HSE Infoline: Callsave 1850 24 1850.
Online: You can apply online for a medical card on medicalcard.ie. This is the quickest method of obtaining the card. The completed form will be returned to you.
Download form: Alternatively, you can download a medical card application form:
Form MC1 (pdf) for people under 70 years
Form MC1a (pdf) for those aged over 70
In both cases 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. Read more about GP services for medical card holders here.
If the GP accepts you as a patient, he/she signs the form.
You should return the form to the HSE Central Medical Card Office, along with documentary evidence of the information that you have provided:
PPS Number (for example, tax certificate, P60 P45, payslip, social welfare book)
- Total household income (for example, payslip social welfare book, notice of tax assessment)
- Outgoings (for example, rent book, mortgage or bank statement, maintenance payments, receipts for child care costs)
- Start date and expected completion date for back to education and back to work schemes
- For people claiming a medical card under EU regulations, the relevant E form from the other EU State
- Travel to work costs (for example, copy of Vehicle Registration Certificate certificate if claiming travel to work by car
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 can track the progress of your medical card application at medicalcard.ie.
The HSE has FAQs on medical cards and medical cards/GP Visit Cards for people aged 70 and over.
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 you will get a GP Visit Card if your weekly income is between €600 and €700 (single person) or €1,200 and €1,400 (married or cohabiting couple). If your income is above the guidelines for the over 70s you can still be assessed for the general medical card and GP Visit Card.
You can also apply for the Drugs Payment Scheme at any age.
Review: The card is usually issued for 3 years after which your eligibility is reviewed. Depending on your circumstances, it may be issued for a shorter period. If your circumstances change, you must inform the HSE, as you may no longer be eligible. If your income or family circumstances change you must inform Client Registration Unit, P.O. Box 11745, Dublin 11, or contact them at LoCall 1890 252 919.
The HSE may also carry out random reviews of continued eligibility, to ensure that people who hold cards are still eligible, based on national guidelines. If you are selected at random for a review, you will receive a personalised letter and review form for completion. You will be notified of the specific date by which the review form must be returned to the Client Registration Unit, P.O. Box 11745, Dublin 11. If you do not return your review form your application cannot be re-assessed and your card may not be re-issued.
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 who were not involved in deciding on your original application.
HSE Central Medical Card Office
Client Registration Unit
P.O Box 11745
Finglas
Dublin 11
Ireland.
Locall:Callsave: 1890 252 919
Fax:01-8343589
Homepage: https://www.sspcrs.ie/portal/medapp/index.jsp
Further information
Background to medical cards for people aged over 70
Between 2001 and 2008, everyone over aged 70 was entitled to a medical card without a means test. After that, a means test was introduced, with effect from January 2009. From January 2009 to 4 April 2013 there were income limits of €700 per week for a single person and €1,400 per week for a married or cohabiting couple. From 5 April 2013 the limits are €600 per week for a single person and €1,200 per week for a married or cohabiting couple.
There were no standard deductions allowable (for example, for income tax)
Other eligible categories of people
Medical cards are usually granted to children in foster care.
You may be entitled to a medical card under EU Regulations if:
- 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. You must not be employed or self-employed, that is, liable to pay 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 or Switzerland. You must not be getting an Irish social welfare payment apart from Child Benefit and you must not be liable to contribute to the Irish social welfare system, that is, to pay PRSI on your income.
Full-time students aged 16-25 who are financially dependent on their parents are normally only entitled to a medical card if their parents have one. Students who are financially independent of their parents, for example, who have income from part-time work, and who satisfy the means test may be entitled to a medical card. . A student getting Disability Allowance will generally be entitled to a medical card.
Related Documents
- GP Visit Cards
Unless you have a medical card or GP Visit Card, visits to family doctors are not free. What is a GP Visit Card and how can you apply? - Medical Card: Examples of capital assessment
Examples of scenarios income + capital - Universal Social Charge (USC)
The Universal Social Charge is a tax payable on gross income that came into effect on 1 January 2011.
Contact Us
If you have a question relating to this topic you can contact the Citizens Information Phone Service on 0761 07 4000 (Monday to Friday, 9am to 8pm) or you can visit your local Citizens Information Centre.