Medical Card Holders - GMS

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 general income guidelines 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. They 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:

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.

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.

Other eligible categories of people

You may get a medical card in certain situations without a means test, for example under EU Regulations. 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.

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.

The charges do not apply to children in the care of the HSE who have their own medical card. This includes children in residential care, foster care, foster care with relatives and other care placements.

General income guidelines

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. 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 assessment of a couple for medical card purposes is based on the age of the older person.

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.
Certain payments made by the State:
  • HSE payments:Foster Care Allowance, Mobility Allowance, Blind Welfare Allowance, weekly supplements paid under the Supplementary Welfare Allowance scheme
  • Social welfare payments: Family Income Supplement, Child Benefit, Carer's Allowance, Domiciliary Care Allowance guardian's payments (for example, orphan's pension) and the Free Fuel, Island, Living Alone and Over 80 Allowances.
  • Other payments: Third level educational maintenance grants, Rehabilitation Maintenance Allowance, earnings from employment of a rehabilitative nature (up to €120.00 per week).

Under 70s: Guidelines on income and capital

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. (There is, however, no exact definition of what 'reasonable expenses' actually means in relation to housing or childcare costs).

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 plus a weekly amount of €50 to cover standing charges (depreciation and running costs). Where a couple needs two cars to travel to work a double allowance applies.

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.

How capital is assessed for the under 70s

All capital (savings and investments) is taken into account for medical card purposes. However, income on the savings/investments or property of €36,000 for a single person and €72,000 for a couple is disregarded.

The disregard figure only applies once where both savings and property (other than your own home) are being assessed.

The balance is taken into account either by taking into account the actual rate of interest received, if you provide a certificate of the interest paid on in the last full calendar year or by using a notional rate. The HSE will use whichever calculation is better for the applicant.

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.

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 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. The calculation of interest includes Deposit Interest Retention Tax. Again, the HSE can apply the notional rate if the applicant wishes.

Property (other than 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.

Some worked examples of how your income will be calculated/assessed.

The HSE has published Medical Card/GP Visit National Assessment Guidelines 2009 for those aged under 70 years.

Over 70s: Guidelines on income and capital

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.

Since January 2009 there are gross income limits of €700 per week for a single person and €1,400 per week for a married or cohabiting couple. There will be no standard deductions allowable (for example, for income tax).

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.

Pensions, earnings, interest from capital and all other sources of income are included in the means test.

Changes in 2013

During 2013 the medical card weekly income limits for people aged over 70 will decrease from €700/€1,400 (single person/couple) to €600/€1,200. This will require legislation.

The medical card will be replaced with a GP Visit card if weekly income is in the range €600–€700 for a single person or €1,200–€1,400 for a couple.

How capital is assessed for the over 70s

Savings or similar investments of €36,000 for a single person and €72,000 for a couple are disregarded. A notional rate of interest will be applied to the balance.

  • The notional rate will be set by the HSE quarterly, by taking an average of the current deposit interest rates of a number of the major Irish banks and building societies on 1 January, April, July and October.
  • Alternatively where the applicant wishes he/she can have the actual rate applied if he/she provides a certificate of interest paid on savings in the last full calendar year and the HSE will apply this method of assessment.
  • 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. The calculation of interest includes Deposit Interest Retention Tax. Again, the HSE can apply the notional rate if the applicant wishes.

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.

Only €14,000 is taken into account: the first €36,000 is disregarded.

The income is counted as 3% of €14,000, which is €420.00 a year or €8.05 a week.

 

Please note that any calculation of interest must include Deposit Interest Retention Tax.

Property 
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 and such costs may include insurance premia, loan/mortgage repayments, maintenance, etc.

Spouse 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 €1,400 a week.

Widowed: If your spouse or cohabiting partner dies after 1 January 2009 and you are aged over 70, you can keep your medical card for 3 years, provided that your income is less than €1,400. 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, or if you are any age and your spouse or cohabiting partner died before 1 January 2009, the relevant income limit for a single person applies.

People who have a medical card issued before 31 December 2008

All existing medical cards for people aged over 70 were valid until 2 March 2009. After that date, they remain valid if the person’s income is below the relevant new limit. The card holders will not have to undergo a means test unless their income is above the limits and they want to apply for a discretionary medical card on the basis of their personal circumstances.

The HSE wrote to all people aged 70 and over informing them about the new arrangements. Only people who have income above the limits were asked to reply to the HSE. Everyone else simply keeps their card.

All medical cards have an expiry date and are subject to review. Currently, medical cards issued under the Health Act 2008 to people aged 70 and over are generally issued for a period of 2 years.

You can also apply for the Drugs Payment Scheme at any age.

The HSE has published Medical Card/GP Visit National Assessment Guidelines 2009 for those aged over 70 years

How to apply

If you have any questions before you send your application you can Lo-call 1890 252 919 or contact your Local Health Office.

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 and people aged over 70 whose income is above the €700/1,400 limit.

Form MC1a (pdf) for those aged over 70 whose income is below the €700/1,400 weekly income limit.

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 (e.g. tax certificate, P60 P45, payslip, social welfare book)

  • Total household income (e.g. payslip social welfare book, notice of tax assessment)
  • Outgoings (e.g. 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 (e.g. 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 www.medicalcard.ie.

The HSE has a Guide to Medical Cards, dealing with frequently asked questions.

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, and your income is above the guidelines for the over 70s you can be assessed for the general medical card and GP Visit Card.

You can also apply for the Drugs Payment Scheme at any age.

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 not involved in deciding on your original application.

Contact Lo-call 1890 252 919 or Local Health Office if you have any questions about medical cards and eligibility.

You can also contact the HSE Infoline: Callsave 1850 24 1850

 

 

HSE Central Medical Card Office

Client Registration Unit 
P.O Box 11745 
Finglas 
Dublin 11 
Ireland. 

 

Further information

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. In this case, the Local Health Office where the student is attending college would issue the medical card. A student getting Disability Allowancewill generally be entitled to a medical card.

Return to work

If you are receiving a social welfare payment and return to work, you may retain your medical card for up to 3 years.