crosscare migrant project
LIVING IN IRELAND: An Integration Website for Migrants living in Ireland

Health

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Introduction to the Irish healthcare system

The Irish healthcare system is divided into public and private services. Both services are provided by GPs and the Health Service Executive (HSE) is responsible for providing public and community health services. There are three types of hospitals: HSE hospitals, voluntary hospitals and private hospitals. For a more comprehensive guide to the Irish Health Service go to www.hse.ie.

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GP services

What is a General Practitioner (GP)?

A General Practitioner (GP) is a doctor who provides health services to people in his/her surgery or in the patient’s home. If you do not have a Medical Card or a GP Visit Card you will have to pay for the service.

There are no set fees in Ireland for GP services. If you wish to check costs, contact your local surgery directly. At present, charges are approximately €60 per visit.

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Public Health Care

If you are “ordinarily resident”, you can access a range of public health services that are free of charge or subsidised by the Irish government. Generally, if you are living here and intend to continue to stay here for at least a year, you will be considered “ordinarily resident”.

There are two types of patient in the public healthcare system:

  • Category 1 - People with Medical Cards (full entitlement to access public health services)
  • Category 2 - People without Medical Cards (limited access to public health services).

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Entitlement to hospital care

What if I have a serious accident or become suddenly very ill – can I go to a hospital Emergency Department (ED)?

Anybody in Ireland with a medical emergency is entitled to attend the Emergency Department. A patient visiting the Emergency Department will either be treated and sent home or will be admitted to a ward as an in-patient.

Note: Different hospitals treat different sicknesses and emergencies, for example, maternity hospitals only treat maternity related emergencies while general hospitals will treat most emergencies.

What are ‘out-patient’ and ‘in-patient’ services?

Out-patient services generally include Emergency Department services as well as planned services, for example, specialist assessment by a consultant or diagnostic assessments such as x-rays, laboratory tests and physiotherapy.

In general, you may refer yourself to the Emergency Department of a public or voluntary hospital. You do not incur hospital charges if you are referred by a GP. You do not have to pay for consultants’ services but you do not have a choice of consultants. If you are a private patient you can choose the consultant.

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 do not remain overnight you are receiving day services.

What are the charges if I go to hospital in Ireland?

This will depend on your personal circumstances and also whether you are accessing ‘out-patient’ or ‘in-patient’ services.

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Out-Patient Charges

If you go to the out-patients or Emergency Department of a public hospital without being referred there by your GP, you may be charged €100. This charge does not apply to the following groups:

  • Medical card holders
  • People receiving treatment for prescribed infectious diseases
  • 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

In cases of excessive hardship, a HSE Area may provide the service free of charge.

If you have to return for further visits in relation to the same illness or accident, you do not have to pay the charge again.

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In-Patient and Day Service Charges

The charge for in-patient/day services is €75 per day up to a maximum of €750 in a year. 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 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

In cases of excessive hardship, a HSE Area may provide the service free of charge.

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National Treatment Purchase Fund

Under the National Treatment Purchase Fund, public patients who are waiting longest for an operation or procedure on a public hospital in-patient or day case waiting list can have their operation in a private hospital: www.ntpf.ie

Ashford House, Tara Street, Dublin 2
Lo-Call: 1890 720 820

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The Medical Card

What is a Medical Card?

A medical card is issued by a Health Service Executive (HSE) Area in Ireland. Medical card holders are entitled to receive certain health services free of charge.

What health services are available free of charge if I have a Medical Card?

  • Doctor visits: A range of GP services from a chosen doctor in your local area
  • Prescription Medicines: The supply of prescribed approved medicines, aids and appliances such as wheelchairs and crutches
  • Certain dental, eye and ear health services
  • Hospital Care: All in-patient services in public wards in public hospitals, including public consultant services
  • Hospital visits: All out-patient services in public hospitals, including public consultant services
  • Maternity Cash Grant on the birth of each child
  • Medical and Midwifery Care for Mothers, including health care related to pregnancy and the care of the child for six weeks after birth
  • Some personal and social care services, for example, public health nursing, social work services and other community care services based on client need

For more information regarding the above, please contact your local Health Centre.

You may also be entitled to the following additional benefits (from the relevant government department)

  • Exemption from paying the health portion of your social insurance (PRSI)
  • Free transport to school for children who live 3 miles or more from the nearest school
  • Exemption from state examination fees in public second-level schools
  • Financial help with buying school books

Am I entitled to a medical card?

Anyone over the age of 16 years who is ordinarily resident in the State is entitled to apply for a Medical Card.

You can qualify for a Medical Card under the following three main categories:

  • Means Test: People (and their dependents) whose income is within the financial guidelines
  • Undue Financial Hardship: People whose income is over the financial guidelines but the HSE decides that the financial burden of medical or other exceptional circumstances would cause undue hardship
  • Automatic: People who are automatically entitled to a Medical Card.

Does the medical card cover my family?

A medical card normally covers you (the cardholder), your spouse and any children under 16 or children who are full-time students aged 16-25 and financially dependent on you.

Where a couple has separate incomes, their application for a medical card is assessed on the basis of their combined income.

How do I apply?

You must contact your nearest Health Centre for an application form or www.medicalcard.ie. If you are under 70 years of age ask for Form MC1 and if you are over 70 years of age ask for Form MC1a.

  • You must complete the application form and get your GP to sign it
  • You must have a Personal Public Service (PPS) number, which you can apply for at your local social welfare office

Medical card assessments based on a means test make allowances for rent or mortgage payments, childcare expenses and travel to work expenses. Income is assessed after tax and PRSI are deducted.

Can I use my Irish medical card if I am abroad on holidays?

No. The medical card is not recognised outside Ireland.

My medical card will expire in 2 months. How can I renew it?

The medical card section will send you are a review form six weeks before your medical card expires. You should complete the form and send it back to them. They will then decide if you still fulfill the requirements for a medical card.

What if I am not eligible for a medical card?

If you are not eligible for a medical card then you will be charged a fee for doctor and hospital services. However, if you do not qualify for a medical card you may be entitled to a reduced rate of medical card under the following schemes:

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GP Visit Cards

This card entitles holders to free GP services; however, they will have to pay for hospital services and a limited amount for prescription drugs. To apply for a GP Visit Card, you use the same application form for a medical card. While your GP Visit Card application is being processed, the HSE will also assess your entitlement for a full medical card.

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Drug Payment Scheme

The Drug Payment Scheme allows individuals and families who do not hold medical cards to limit the amount they have to spend on prescribed drugs. Under the Drug Payment Scheme, you will not pay more than €100 in any calendar month for approved prescribed drugs, medicines and appliances.

If you are ordinarily resident in Ireland, you are eligible to apply for the Drugs Payment Scheme. You can use the Drug Payment Scheme in conjunction with a Long Term Illness Book. Application forms are available from your local pharmacy or contact your local health centre for more information.

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Long-Term Illness Scheme

The Long-Term Illness Scheme allows people with certain conditions, who are not already medical cardholders, to obtain the medicines and medical and surgical appliances they require for the treatment of their condition, without charge. You do not have to satisfy a means test. The conditions included in the scheme are:

  • Acute leukaemia
  • Mental handicap
  • Cerebral Palsy
  • Mental illness (in a person under 16)
  • Cystic fibrosis
  • Multiple sclerosis
  • Diabetes insipidus
  • Muscular dystrophies
  • Diabetes Mellitus
  • Parkinsonism
  • Epilepsy
  • Phenylketonuria
  • Haemophilia
  • Spina bifida
  • Hydrocephalus
  • Conditions arising from the use of Thalidomide

If approved, you will be issued with a long-term illness book. Your pharmacist will provide you with the necessary drugs free of charge.

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Maternity and Infant Services

The Health Service Executive provides free maternity services for the period of pregnancy and for 6 weeks after the birth. The service is provided by your GP. You must be ordinarily resident in Ireland to avail of this service.

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Health Services for People with Disabilities

The Disability Act 2005 allows for an assessment of the needs of a person with disabilities. For more information on health services for people with disabilities go to ‘Health Information’ on www.dohc.ie

Where can I get more information?

Contact the HSE infoline from 8am to 8pm, Monday to Saturday.
Callsave: 1850 24 1850
Email: info@hse.ie
Website: www.hse.ie

The Migrant Disability Network Ireland (MDNI) aims to provide expert and compassionate support to children from migrant/minority backgrounds who are living with physical/intellectual disabilities. Website: www.migrantdisabilitynetwork.com

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Private Health Care

You can avail of private health care if you can pay for it directly or you are covered by a private health insurance policy. Some employers offer health insurance as part of an employment package.

It is usual practice that no immediate private health insurance coverage is available for medical conditions existing before taking out a private health insurance policy. The restriction shall be removed upon the following periods of continuous membership: 5 years for members under 55; 7 years for members aged 55-59; 10 years for members aged 60 and over.

I want to buy private health insurance, how can I do this?

You can contact one of the private health insurers in Ireland.

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Mental Health

Many people experience mental health problems over the course of their life. You can access mental health services through your GP or through the community and hospital based services offered by the HSE.

There are also voluntary organisations which support people with mental health illnesses:

Aware provides information and support for people suffering from depression and their family and friends: www.aware.ie

LoCall: 1890 303 302

Console supports and helps people bereaved through suicide: www.console.ie

Freephone: 1800 201 890

Samaritans is a confidential emotional support service for people experiencing feelings of distress or despair: www.samaritans.org

CallSave: 1850 60 90 90

Headstrong is an initiative working with communities to ensure that young people aged 12 to 25 are better supported to achieve mental health and wellbeing: www.headstrong.ie

Telephone: 01 6607343
Email: info@headstrong.ie

The HSE developed a website as part of the ‘Your Mental Health’ campaign to raise awareness about mental health issues: www.yourmentalhealth.ie

The National Office for Suicide Prevention co-ordinates suicide prevention efforts throughout the country: www.nosp.ie

Population Health Directorate
HSE, Dr Steeven’s Hospital, Dublin 8
Telephone: 01 6352139 / 6352179
Email: info@nosp.ie

Mental Health Ireland is a national voluntary organisation which aims to promote positive mental health and to actively support persons with a mental illness, their families and carers by identifying their needs and advocating their rights: www.mentalhealthireland.ie

6 Adelaide Street, Dun Laoghaire, Co. Dublin
Telephone: 01 2841166

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Alcohol and Drug Abuse

Drinking alcohol plays a role in adult life in Ireland. However, alcohol is often abused. The following organisations provide information and support on alcohol and drugs:

Drugs Helpline – Freephone – 1800 459 459 (Monday – Friday): www.drugs.ie

The HSE set up a website to provide information on alcohol and its effects on health: www.yourdrinking.ie

Alcohol Action Ireland is the national charity for alcohol-related issues: www.alcoholireland.ie

Butler Court, 25 Great Grand Street, Dublin 1
Telephone: 01 8780610
Email: info@alcoholactionireland.ie

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Reproductive healthcare

Reproductive healthcare includes crisis pregnancy options, family planning, contraception, pregnancy counseling and related health matters, for example, domestic violence, sexually transmitted diseases, miscarriage, still birth and sudden infant death, circumcision and rape. Your GP can provide you with information on reproductive health. However, some people do not feel comfortable about discussing these issues with their GP.

Irish Family Planning Association is a charitable organisation which provides sexual and reproductive health information, clinical services, counseling service education, training and awareness raising: www.ifpa.ie

Solomons House, 42A Pearse Street, Dublin 2
Telephone: 01 6074456
Email: post@ifpa.ie

The Dublin Well Woman Centres were founded to provide access to family planning advice and services. There are three medical centres in Dublin: www.wellwomancentre.ie

Head Office, 25 Capel Street, Dublin 1
Telephone: 01 8749243
Email: info@wellwomancentre.ie

Clinics:

67 Pembroke Road, Ballsbridge, Dublin 4
Telephone: 01 6609860 / 6681108 / 6683714

35 Lower Liffey Street, Dublin 1
Telephone: 01 8728051 / 8728095

Northside Shopping Centre, Coolock, Dublin 5
Telephone: 01 8484511

For more information on reproductive health see www.treoir.ie and go to ‘Publications’ and ‘Reproductive health for migrant women’.

Dublin AIDS Alliance (DAA) Ltd is a voluntary organisation working to improve conditions for people living with or affected by HIV and AIDS: www.dublinaidsalliance.ie

53 Parnell Square West
Dublin 1
Telephone: 01 8733799
Email: info@dublinaidsalliance.ie

DAA's Don't Panic Guides give an overview of sexual health and sexual health services in Dublin in a variety of languages.

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Health Campaigns

CervicalCheck

CervicalCheck is a programme providing free smear tests to women aged 25 to 60 who are eligible for screening. Cervical screening is the most effective method of reducing a woman’s risk of developing cervical cancer. A smear test is used for cervical screening and is a simple procedure to detect pre-cancerous cells. For more infomation in different languages go to: www.cervicalcheck.ie

Freephone: 1800 45 45 55

BreastCheck

BreastCheck is a programme providing screening for breast cancer and invites women aged 50 to 64 for a free mammogram on an area-by-area basis every two years: www.breastcheck.ie

Freephone: 1800 45 45 55

Bowel cancer awareness

There is no bowel cancer screening programme in Ireland at present.

If you think that you are at risk of bowel cancer you should contact your GP or the Irish Cancer Society’s Information Service: 1800 200 700 (Monday–Thursday 9am–7pm; Friday 9am–5pm).

Prostate Cancer Awareness

There is no prostate cancer screening programme in Ireland. The Irish Cancer Society created the Action Prostate Cancer initiative to increase information and support about this cancer: www.cancer.ie/prostate

Prostate Cancer Information Service 1800 380 380 (Monday – Thursday 9am – 7pm; Friday 9am – 5pm).

For more information on migrant health issues contact:

Cairde: www.cairde.ie or www.healthfacts.ie

Cairde is a community development organisation working to tackle health inequalities among ethnic minority communities by improving ethnic minority access to health services and ethnic minority participation in health planning and delivery.

19 Belvedere Place, Dublin 1
Telephone: 01 8552111
Email: info@cairde.ie

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Supported by

This project is co-financed by the European Commission under the European Integration Fund and is supported by the Office for the Promotion of Migrant Integration in the Dept of Justice & Equality & Pobal.