Illness in your retirement

Information

While the vast majority of retired people enjoy a healthy life, there are some who suffer illness and disability and may need care. Some may have retired because of the onset of illness or disability. The payments and services to which you are entitled depend on your age and on your needs. You may meet the conditions for more than one weekly payment but as a general rule, you may receive only one weekly payment. The Department of Social Protection (DSP) is responsible for the payments mentioned below except where otherwise stated.

Income supports for older people

Pensioners

If you are already a pensioner (aged 65 or over) when you become ill or acquire a disability your income arrangements do not change; you continue to receive your pension and other entitlements.

Employed

If you are employed you may continue to be paid by your employer but this depends on your contract of employment. Employers are not obliged to pay employees who are unable to work because of illness but some contracts of employment include provisions for payment while ill. This applies regardless of age.

Aged Under 66

If you become ill and unable to work before the age of 66, you may be eligible for Illness Benefit. Your GP will have application forms.

Illness Benefit is based on PRSI contributions. If you do not qualify because you do not have enough PRSI contributions or because you are self-employed, you may be eligible for a weekly Supplementary Welfare Allowance. Apply to the Department of Social Protection's representative in your Local Health Office or health centre. These cease to be payable at age 66.

If your illness or disability arises from a work-related accident or illness you may qualify for Occupational Injuries Benefit.

Long-term illness and disability

If you have a long-term illness or disability and cannot continue to work, you may be able to claim your occupational or personal pension scheme if you have one and you may qualify for Illness Benefit. If you remain unable to work for a year or more you may qualify for Invalidity Pension. If you do not qualify for Illness Benefit or Invalidity Pension, you may apply for the means-tested Disability Allowance.

If you qualify for Invalidity Pension or Disability Allowance, you may also qualify for Free Travel and the Household Benefits Package. If you have problems paying your rent or mortgage, you may be able to get help from your Local Health Office or Health Centre under the Rent and Mortgage Interest Supplement scheme.

The Supplementary Welfare Allowance scheme may also provide help with various costs such as special diets, heating, exceptional needs and urgent needs.

Housing options

There are a number of housing grants available for older people and people with disabilities. If your home needs to be adapted to enable you to continue to live there, you may qualify for the Housing Adaptation Grant for People with a Disability. The adaptations could include adding on an extra room, making the house wheelchair accessible or putting in a ground-floor bathroom and toilet. Apply to your local authority. There are considerable delays in getting this grant in many areas. The Health Service Executive (HSE) also provides grants under the Housing Aid for Older People Scheme and the Mobility Aids Grant Scheme.

If your own home is unsuitable you may be able to get a specially adapted local authority house for older people and people with disabilities, or an adapted house provided by a voluntary housing organisation. The availability of such houses and eligibility for them vary around the country.

Care at home

If you are in need of care, the HSE may provide it or help you to pay for it. Your carer may also be able to get a payment from the Department of Social Protection.

Help with home care

If you need support in order to enable you to continue to live at home, you may be able to get help from the Community Care Services section of the HSE. The help you may get includes home help and public health nursing. In theory everyone with a medical card is eligible for public health nursing services but availability varies considerably. The home help service is discretionary and, again, availability varies from one area to another.

If you need full-time care you may get help from the HSE under the Home Care Support Scheme. This may include a Home Care Grant which you may use to employ carers.

Home care supports under this scheme operate differently in different parts of the country. In some areas, the HSE directly provides care services at home or arranges for their provision by voluntary organisations or the private sector. In other areas, it pays a grant which you may use to employ carers privately.

At present there is no standard means-test for qualifying for the Home Care Support Scheme; in some areas, it seems that the HSE applies the nursing home subvention means-test. It is intended that these packages will be standardised throughout the country and the same conditions and criteria should apply no matter where you live. It is not clear when this will actually happen. There are a number of agencies which arrange for the provision of home carers to people who need them. There are no particular rules applying to these agencies and you engage with them in accordance with the terms of the contract you sign.

You may qualify for tax relief on the costs of employing a carer for a family member, either directly or through an agency. The maximum allowance is €50,000.

Income support for carers

Apply to the Department of Social Protection for the following payments:

Carer's Allowance

This is a means-tested payment to people who provide full-time care to an older person or a person who is incapacitated. Those who look after more than one person may be eligible for an additional 50% of the maximum rate of the payment. If you receive a Carer's Allowance, you are eligible to claim Free Travel and the Household Benefits Package in your own right (provided that your household is not already getting the package).

The means-test for the Carer.s Allowance takes income and savings into account, but not your own house. The first €332.50 of the carer's earnings is disregarded. In the case of a married or cohabiting couple the first €665 of the couple's combined weekly income is disregarded.

You can work or take education or training courses for up to 15 hours a week, as long as you make adequate arrangements for the care of the person who needs full-time care and attention and inform the Department of Social Protection.

Half-rate Carer's Allowance

Until September 2007 you could not claim the Carer's Allowance if you were getting another social welfare payment. Now you can claim a Half-rate Carer's Allowance and keep your original payment.

Carer's Benefit

This is a social insurance payment for people who give up work to care for a person who is incapacitated and who needs full-time care and attention. It may be paid for up to two years and increases are paid if you have child dependants. If you look after more than one person, you may be eligible for an additional 50% of the maximum payment. You must be between the ages of 18 and 66 and have enough PRSI contributions to be eligible for Carer's Benefit. You may be eligible for Carer's Leave from your employment.

You can work or take education or training courses for up to 15 hours a week, as long as you make adequate arrangements for the care of the person who needs full-time care and attention and inform the Department of Social Protection.

If you are employed or self-employed, you must not earn more than €332.50 per week.

Respite Care Grant

The Respite Care Grant is available to all carers providing full-time care to an older person or a person with a disability regardless of means. The only people excluded are those getting an unemployment payment or those who are working outside the home for more than 15 hours per week. The grant is paid in June each year. You get this payment automatically if you are getting a carer's payment, otherwise apply to the Department of Social Protection.

Mobility Allowance

Mobility Allowance is a HSE payment to people who are unable to walk or use public transport and who would benefit from a change of surroundings. There are a number of other transport supports, such as the Motorised Transport Grant and tax concessions which are available to people with disabilities.

Medical Services

Medical card/GP visit card

You may qualify for a medical card. You must normally satisfy a means-test (unless you qualify under EU rules or because you are suffering from Hepatitis C). A medical card entitles you to free GP services and free hospital services. From October 2010, there is a 50 cent charge per prescription item for medical card holders, subject to a monthly ceiling of €10 per family.

If you are aged under 70 years and do not qualify for a medical card because your means are too high, you are automatically assessed for a GP Visit Card, which has higher income guidelines. This entitles you to free GP services but you may have to pay some of the cost of prescribed drugs.

Long-Term Illness Scheme

Under the Long-Term Illness Scheme drugs, medicines and some approved appliances prescribed for the treatment of the following medical conditions are available free of charge:

Medical conditions covered by the Long-term Illness Scheme

Mental handicap Phenylketonuria Cystic fibrosis Haemophilia Mental handicap Phenylketonuria Cystic fibrosis Haemophilia Cerebral palsy

Epilepsy Diabetes mellitus, diabetes insipidus Multiple sclerosis Muscular dystrophy Parkinson.s disease Acute leukaemia Spina bifida Hydrocephalus

The card issued for this scheme lists the drugs and medicines for the treatment of the holder's condition. It does not cover them for drugs and medicines not connected with the original condition.

Drugs Payment Scheme

The Drugs Payment Scheme is for people without medical cards where the individual/family must pay the first €132 per month (from January 2012) of costs incurred on approved prescribed drugs and medicines. Application forms are available from your local pharmacy, Local Health Office or health centre.

Hospital Charges

Everyone is eligible for public hospital services. If you opt for private hospital care, you have to pay the total costs involved. Some or all of these costs may be covered by private health insurance.

In-patient charges

There is a charge of €75 per day for in-patient services in a public ward. This is subject to a maximum of €750 in any period of 12 consecutive months. Medical card holders and certain other groups do not have to pay these charges. There is a provision for non-payment in cases of hardship. In this case you should write a letter to the hospital explaining your circumstances.

If you spend more than 30 days in hospital you may have to pay long-stay charges; see Moving from home to long-term Care.

Out-patient charges

There is no out-patient charge if you are referred by a doctor but otherwise a €100 charge (from January 2009) may apply to your initial visit to a hospital.s Accident and Emergency department. If you have to return for further visits in relation to the same illness or accident you don.t have to pay the charge again. Medical card holders and some other groups are exempt from this charge.

Income tax

You can claim medical expenses against income tax paid. You must first make any other claim that you can, for example the HSE Drugs Payment Scheme or private medical insurance.

If you employ a carer for a family member, either directly or through an agency, you may qualify for tax relief. The maximum allowance is €50,000. View further information on this matter in the Revenue Commissioners leaflet IT47 Employed Person Taking Care of an Incapacitated Individual (pdf).