The Health Budget in 2021 will be €22 billion, more than 60% higher than five years ago. It will support 16,000 extra staff and an extra 2,500 beds in hospital and community settings. This continues the implementation of Sláintecare, but responding to COVID dominates the new Winter Plan.
  • Primary Medical Cover: A Medical Card entitles you to most health services free. A GP Visit Card covers the cost of visits to the doctor. The means test for these cards is based on net income i.e. after the deduction of tax and PRSI; of reasonable expenses: (on rent or mortgage; on travel to work; on childcare and on regular weekly out-of- pocket medical expenses). Savings in excess of €36,000 (single) €72,000 (couple) are valued in the same way as in Social Welfare means-test. The cards will be granted if your family’s remaining income after these deductions does not exceed the following guidelines for 2021:

The HSE will consider cases outside these guidelines on exceptional hardship grounds. Medical Card holders do not have to pay student exam fees. Persons with British or EU pensions, who have no Irish Social Welfare pension, generally qualify for the Medical Card regardless of income. Students will only qualify for a Medical Card in their own right if they have an independent income of at least €164 (this can include a student grant which would not count in the Medical Card means-test).

  • Persons aged 70+ all now qualify for free GP services without a means test, and qualify for a Medical Card if their gross weekly income is less than €550 per week (single), or €1,050 (couple) (from 1st Nov 2020). In the means test, the first €36,000 (single), €72,000 (couple) of savings and investments are disregarded. On the balance, you can opt that only the income actually earned will be counted, by submitting either a certificate of interest or details of the savings product. If significant savings are involved this is more favourable than using the Social Welfare method.
  • Children under 6 qualify for a GP Card regardless of parents’ means. This will be extended gradually to age 12.
  • From 1st Nov 2020, a lower €1.50 charge per prescription item applies to Medical Card holders (max €15 per month per family) and for those aged 70 it will be €1 per item (max €10 per month). Prescription charges do not apply to those on the Long-term Illness Scheme.
  • Drug Refund: Any individual or family can get a refund on the cost of prescribed drugs used in any month in excess of €114 (from 1st Nov 2020) provided the drug is on the Government list.
  • General Hospital Entitlements: Everyone is entitled to public in-patient and out-patient hospital services. However, if you see a consultant privately, you will have to pay privately for any test or care arising, unless you give notice that you wish to switch back to join the public waiting list for the treatment. The National Treatment Purchase Fund is now contacting Public Patients waiting longest across 50 different procedures, offering the option of having the procedure done immediately in another hospital as a private patient without charge.
  • Refund for Treatment Abroad: The HSE will refund the cost of treatment in another EU country, provided your consultant applies in advance, confirms that the treatment is justifiable and is not available in sufficient time in Ireland. Some travel expenses are also covered (Tel: 056 7784548 or email:
  • Charges: With the exception of Medical Card holders, and children with long-term ailments or referred from school health examinations, the following charges must be paid in major public hospitals:
    Casualty and Outpatients pay €100 unless referred by your doctor or admitted to hospital.
    Public patients pay €80 per night (up to a max €800 in a year).
    Private patients pay a full charge even if they are in public wards.
  • Nursing Home Support: Under the “Fair Deal” patients seeking longterm residential care are entitled to means-tested support subject to a Care Needs Assessment. The patient will be liable to pay towards the cost of care:

– 80% of assessable income (i.e. after deduction of tax, PRSI, mortgage/rent and out-of-pocket medical expenses)
– plus 7.5% of the value of any assets (net of borrowings against them). The first €36,000 (single), €72,000 (couple) of assets are disregarded.

  • A spouse is assessed with half of the couple’s joint income and assets. The HSE can assess assets transferred in the past 5 years. The balance of the cost will be met by the State. If the assets are in property, the contribution can be deferred until settlement of the person’s estate, but the money owing will be increased by the Consumer Price Index each year. In the case of the family home and of the assets of a family business where a family successor continues to run it for at least six years, the contribution will only be paid for a maximum of three years and so capped at 22.5% of its value (or 11.25%, if covering one spouse). The deferred charge against the home will not be collected during the lifetime of a surviving spouse or a disabled child.


  • Older people or those with incapacities can get grants for home improvements from the Council, subject to income limits, but your application may be prioritised based on medical need.
  • Housing Aid For Older People: Up to 95% grant in owner-occupied homes, for persons aged 66 or over, to cover the costs of up to €8,000 in necessary improvements – rewiring, central heating (where none), replacing boilers beyond repair. Annual income of all household members must be under €30,000 for the full grant, dropping on a graduated basis to 30% for incomes €50,000-€60,000, but no grant after that.
  • Mobility Aids: Up to 100% grant to cover the costs of up to €6,000 in works to address mobility problems, certified by a doctor (e.g. rails, ramps, stairlifts and level access shower) in owned or private rented homes where the annual income of all household members is under €30,000.
  • Housing Adaptation (Disability): Up to 95% grant to cover the costs of up to €30,000 in works to adapt a home to suit the needs of a person with an enduring disability (e.g. downstairs toilet shower, wheelchair adaptation, extension, etc.) in owned or private rented homes. The works must be certified necessary by a doctor and may require an Occupational Therapist Report. Annual income of all household members must meet the same test as for Housing Aid for Older People.

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