Charges for hospital services

Rules

Charges for accident and emergency/casualty services in public hospitals

If you go to the accident and emergency or casualty department of a public hospital without being referred there by your family doctor (GP), you may be charged €100 (from 1 January 2009).

There is no charge if you are referred by a GP.

The charge of €100 also does not apply to the following groups:

• Medical card holders
• People who are admitted to hospital as a result of attending the casualty department (you will then be subject to in-patient charges)
• People receiving treatment for prescribed infectious diseases
• Children up to six weeks of age, children suffering from prescribed diseases and disabilities and children referred for treatment from child health clinics and school health examinations
• People who are entitled to hospital services because of EU Regulations
• Women receiving maternity services.

If you have to return for further visits to an out-patient clinic in relation to the same illness or accident, you should not have to pay the charge again.

You can be referred by your family doctor to the out-patients department of a public hospital for specialist assessment by a consultant or his or her team or for diagnostic assessments (i.e., x-rays, laboratory tests, physiotherapy, etc.). If you attend this service as a public patient, you will not have to pay for this service. If you wish to attend a consultant in a private capacity, you must pay their fee.

In-patient charges in public hospitals

If you are in a public ward under the care of a consultant for treatment and you remain overnight, you are receiving in-patient services.

If you are admitted to the hospital under the care of a consultant where you do not require the use of a bed overnight and your discharge from hospital is planned, you are receiving day services.

The charge for in-patient/day services is €75 per day up to a maximum of €750 in a any 12 consecutive months. The charge does not apply to the following groups:

• Medical card holders
• People receiving treatment for prescribed infectious diseases
• People who are subject to "long stay" charges
• Children up to six weeks of age, children suffering from prescribed diseases and disabilities and 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.

Private patients in public or voluntary hospitals

If you are in a private bed in a public or voluntary hospital, you must pay for your maintenance at a rate set from time to time. The following charges are in addition to the public hospital in-patient charges, as above.

Rates in 2011 are:

If you are a private patient, you must pay for the services of the consultant who is treating you. You must also pay for the services of any other consultant who is involved in caring for you (i.e., the radiation oncologist, anaesthetist, etc.)

Mental health services

You have the same entitlement to public health services for mental illness as for any other illness. You must pay for maintenance and treatment in private psychiatric hospitals. Health insurance companies sometimes treat psychiatric hospital costs differently from general hospital costs. The same rules apply to long-term institutional care for psychiatric patients as to long-term institutional care for other patients.

Mental health in-patient and out-patient services are provided free of charge to children aged under 16 years who are suffering from mental illness.

Long-stay patients

The HSE may impose hospital charges on long-stay or extended care patients, separately from the normal in-patient charges. If you have been an in-patient for more than 30 days within the previous 12 months, you will be liable for these charges. This applies to everyone, including medical card holders.

The Health (Charges for In-Patient Services) Regulations 2005 provide for different charging arrangements, depending on the level of nursing care being provided.

From 23 July 2011, the maximum charge for anyone in public long-stay care is €175.00 per week. Everyone must have at least €33.00 left. In addition, those in public long-stay care are divided into two groups;

• Class 1: those receiving in-patient services in premises where nursing care is provided on a 24 hour basis. Maximum weekly charge for care will be €175.00, or their weekly income less €33.00, whichever is the lesser.
• Class 2: those receiving in-patient services in premises where nursing care not provided on a 24 hour basis. Maximum weekly charge will be the lesser of €130.00, or the person's weekly income less €64.00, or 60% of the persons weekly income.

If you are in hospital for more than 30 days and a doctor certifies that you do not need medically acute care and treatment you may be charged as if you were receiving long-term residential care services.