The State Healthcare System
Healthcare in Ireland is free and you do not need to contribute to the Irish social security system to receive treatment. Indigenous citizens qualify by birth. Citizens from the European Economic Area (EEA), which consists of all EU member states and Norway, Liechtenstein and Iceland, qualify because Ireland has a reciprocal health agreement with all EEA member states. Foreigners from outside of the EEA must be able to show that they qualify for ordinary residence and will remain resident in the country for at least a year by producing an residence or work permit, proof of property ownership or a valid rental agreement, or in the case of students, proof of college registration. All foreigners from outside of the EU must also show evidence of an Irish bank. If you qualify for ordinary residence, your dependant family members must also qualify in order to receive free healthcare. Citizens do not fall into the above group will have to pay for all medical treatment, although emergency treatment may be given free depending on necessity.
Category 1: Medical Cardholders
You must hold a medical card either issued by the Health Board in Ireland or from your home country within the EEA. This entitles you to free medical treatment, which includes doctors’ visits and treatment, prescription medicine, inpatient and outpatient hospital care, dental treatment, eye tests and treatment by an optician, aural treatment and appliances and maternity and infant care. If you come from outside of the EEA, you can apply for a medical card, but it is means tested according to your income. The income limit is changed each year and is measured according to age and family status.
Category 2: Citizens without Medical Cards
People who do not qualify for a medical card receive a letter from the Department of Health and Children confirming their entitlement to category two benefits. This means that you must pay for any visits to a doctor, prescription medicine, inpatient hospital care, emergency ward treatment, routine dental treatment, eye tests and treatment by an optician and aural treatment and appliances. Out patient treatment in a state hospital and maternity care is free. All old age pensioners over the age of 65 are entitled to visits by a nurse and, if necessary, occupational therapy.
Ireland has two recognised private health insurers, the Voluntary Health Insurance known as VHI (www.vhi.ie) and BUPA (www.bupaireland.ie). If you have private health insurance from your home country, it may be transferable to one of the recognised Irish insurers without penalty. VHI and BUPA premiums are gauged according to a community rating. All members contribute the same amount and premiums do not rise with age. Therefore young people over the age of 21 (with VHI) and 18 (with BUPA) pay more than they would if they subscribed to a risk based system.
Private health patients can choose the hospital of their choice, depending on the level of their insurance cover.
There are a high number of doctors per head of population in Ireland. GP’s are responsible for general health, prescribing drugs, treating serious illnesses, and providing preventive healthcare and health education and you cannot attend an Irish hospital without a referral from your doctor, unless your case is an emergency. Medical cardholders are sent a list of ‘approved’ doctors and can register with any doctor on the list. If you are treated by anyone other than an ‘approved’ state funded doctor, you will have to pay the fees yourself. To register with a doctor, you make a contract between the two of you. You can change to a different doctor, but beware of the reason you give for your change, as many Irish doctors are reluctant to take on patients who have had a disagreement with their previous doctor.
Most of the doctors in the country operate from a single or two-man practice. If you register with a doctor in a group practice, you can be treated by one of the other doctors in the practice, when your own doctor is absent.
There are not many state hospitals in Ireland, but they do contain the latest technology and staff are highly qualified.
There are four classes of hospital; the general hospital located in major towns provides in and outpatient care and emergency treatment. Areas that are more rural are served by district or regional hospitals, which offer maternity care and general care but they do not have emergency facilities; district hospitals offer less facilities than regional hospitals. Specialist hospitals are mostly based around the capital, Dublin and specialise in certain kinds of illness or disease.
You may specify the hospital at which you wish to be treated, but there is no guarantee that your choice will be met.
Hospital accommodation consists of wards containing six beds. Some of the wards are mixed sex wards. There are also private and semi private rooms available containing up to four beds, but these are usually reserved for intensive cases or patients who are prepared to pay.
Ireland has several small walk-in medi-centres, where you can receive treatment regardless of whether you are registered or not and you do not need an appointment. Most towns and cities have ‘after-hours clinics’ which operate outside of normal surgery hours and deal with minor complaints.
Emergency wards are located in all main hospitals and are open 24 hours a day. There may be a charge for ambulance transportation.
Most Irish dentists are in private practice. Only children and medical cardholders qualify for free dental care. You are free to register with the dentist of your choice so long as he is state approved. Many dentists no longer participate in the scheme because they deem the state payments to be inadequate.
Chemists sell a wide range of over-the-counter medicine, which is also available in other retail outlets. They are usually open from 9am until 6pm six days a week and some have late night opening hours too. There is no emergency or out of hours chemist and those in need of urgent medicine must go the emergency ward.
Prescription medicine is free to medical cardholders. All other patients must pay some of the cost of their medicine, but if you have multiple prescriptions you can participate in a bulk ordering scheme, but you must register with your local pharmacy or Health Board to qualify.
If you suffer from illness such as diabetes or epilepsy, you will qualify for free prescriptions by obtaining a long-term illness book, which records your requirements.
Pharmacists are qualified to provide advice and consultations regarding minor complaints.