Community Medical Schemes
Medical Cards (General Medical Services Scheme or GMS)
A medical card entitles holders to a range of health services. These include:
- Family doctor service, including a choice of family doctor
- Prescribed medicines
- Prescribed medical appliances where available
- Out-patient services at hospital
- In-patient services in a public ward in a public hospital
- Consultant services
- Mother and baby services
- Dental, eyes and ears services
- Public health nursing services
Getting a medical card involves completing an application form which can be collected from your local community care centre or can be downloaded from the HSE website. A prescription charge / payment of €2.50 per item is required if you are supplied a drug, medicine or surgical appliance (up to a maximum charge of €25.00 per family per month). Download information here.
GP Visit Card
GP visit card holders are entitled to the services of a General Practitioner free of charge. The application process is the same as that for medical cards and the relevant form can be downloaded from the HSE website. Additional allowances will be given for:
- Reasonable expenses incurred in respect of rent/mortgage payments
- Reasonable expenses incurred in respect of childcare costs
- Reasonable expenses incurred in travel to work
The assessment of eligibility for Medical Cards and GP Visit Cards will be based on the combined income of the applicant and spouse (if any) after tax and PRSI have been deducted. Applicants, whose weekly incomes are derived solely from Social Welfare or Health Service Executive allowances/payments, which are in excess of the financial guidelines (either at first application or on renewal), will be granted Medical Cards.
Discretionary Hardship Scheme
The discretionary hardship scheme covers medical card holders who require medication or items prescribed my your doctor that are not covered under the medical card schemes. Items supplied include certain mineral and nutritional deficiency products, skin creams, cardiac drugs, some dressings and certain sunscreens (generally SPF 50+) etc. items not covered include:
- Over the counter medicines advertised to the public
- Simple emollients where suitable alternatives are available under the GMS
- Vitamins and certain dressings
The application is assessed by your local health centre or through your local pharmacist depending on where you live in Ireland. Forms are available to download here. The HSE will consider both the financial circumstances of the individual and how important the prescribed medication or item is to their needs.
Long Term Illness Scheme
This scheme entitles individuals to obtain medicines and appliances free of charge irrespective of means. It applies only to persons suffering from any of the following diseases or disabilities:
- Mental Handicap
- Spina Bifida
- Multiple Sclerosis
- Parkinson’s Disease
- Mental Illness (persons under 16 only)
- Diabetes mellitus
- Muscular Dystrophies
- Cerebral Palsy
- Diabetes Insipidus
- Acute Leukaemia
- Cystic Fibrosis
The Long Term Illness Scheme causes much confusion as it does not cover all long-term illnesses. The above list of diseases and disabilities covered by the scheme was decided in Regulations made by the Minister for Health under the Health Act 1970 (The Health Services (Amendment) Regulations, 1971, S.I. 277/1971). Successive governments have resisted attempts by patient organisations to extend this list to people suffering from other long-term conditions, leading to an unjust situation in which life-long conditions like psoriasis are not considered ‘long-term illnesses’ under the Scheme.
This scheme relates to the supply of advanced treatments like biologics (injectable drugs). A high-tech prescription is usually issued by the consultant in a hospital and given to the patient to bring to their pharmacy for dispensing.
Where the patient has a medical card or the medicine is for a specific condition covered by the Long Term Illness Scheme they do not pay anything, otherwise they pay the first €144.00 a month of the cost in accordance with the rules of the Drugs Payment Scheme.
Drug Payment Scheme
All Irish residents who do not have a medical card should apply for a drug payment (DPS) card. Under this scheme a family pays no more than €124.00 per month (effective from 1 April 2019) for prescribed medicines and appliances listed under the scheme. It covers:
- The applicant
- His/her spouse
- Dependants under 18
- Dependants between 18-23 who are in full time education
- A dependant with a physical or mental disability or illness who cannot maintain themselves fully, who is ordinarily resident in the family home and who does not hold a current medical card.
Patients using the Long Term Illness Scheme but whose medication is not covered under that scheme should also apply for the Drugs payment Scheme. Application forms can be collected from any pharmacy or local community care centre.
Drug Refund Scheme
If a patient/family spends over €124 in a month they can claim back the excess by completing one of forms available from your local community care centre.
Travel Abroad Scheme
The HSE operates a Treatment Abroad Scheme (TAS) for people entitled to treatment in another EU/EEA member state. The TAS provides the cost of approved treatments in another EU/EEA member state or Switzerland. More.
Cross Border Healthcare Scheme
The HSE operates a Cross-Border Healthcare Directive (CBD), for people entitled to public patient healthcare in Ireland who want to avail of that healthcare in another EU/EEA* member state under Directive 201/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patient’s rights in cross-border healthcare, as per the procedures set out in governing EU Regulations and Directives and Irish legislation. The scheme does not cover access to drug therapies that are not currently provided for in the public healthcare system in Ireland, but will cover costs up to the cost of procedure in the Irish healthcare service. More.
Tax Relief on Medicines
The cost of most prescribed medication can be claimed back against your tax. At the end of the year your pharmacist can print you out a copy of all medication dispensed to you that year. Your yearly print out, in combination with a completed MED 1 form should be brought to your local tax office for processing. Other medical expenses which can attract tax relief include chiropody, podiatry and physiotherapy services prescribed by a doctor, specialised dental treatment, hearing aids and gluten free products for coeliacs to mention a few. From more information contact your local tax office or visit www.revenue.ie.
Date of review March 2017