Health Budget Changes 2010

December 21st, 2009 - Pat Breen

• Primary Medical Cover: A Medical Card entitles you to all health services free. A GP Visit Card covers the cost of visits
to the doctor for your family. 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 of regular weekly out of pocket medical
expenses. Savings are valued in the same way as for non-contributory OAP. The cards will be granted if your remaining
income after these deductions does not exceed the following guideline for 2010:

Medical Card GP Only
Under 66 66 and over Under 66 66 and over
• Single living alone €184.00 €201.50 €276.00 €302.00
• Single living with family €164.00 €173.50 €246.00 €260.00
• Married couple (or single parent) €266.50 €298.00 €400.00 €447.00
Additional Allowance for Dependent Children: Medical Card GP Only
• for fi rst two children under 16 €38.00 €57.00
• for other children under 16 €41.00 €61.50
• for fi rst two children over 16 €39.00 €58.50
• for other children over 16 €42.50 €64.00
• for over 16 in full time third level (no grant) €78.00 €117.00
Persons on Social welfare who have no other income will generally qualify for a medical card. An increase in Social Welfare will
not cause you to lose your card.
The HSE will consider cases outside these guidelines in special circumstances, for example to cover one family member with
high medical costs. Medical Card holders do not have to pay the health levy nor exam fees for children. 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 €204.30 but
under the above guidelines.
• Persons aged 70+ qualify for a Medical Card if your gross weekly income is less than €700 per week (single), or
€1,400 (married).
• Once either spouse qualifi es at 70, both get cover.
• A surviving partner aged 70+ will be allowed to keep their medical for three years.
• In the means test, the fi rst €36,000 (single), €72,000 (couple) of assets are disregarded. On the balance only the
income actually earned will be counted.
• From 1st April 2010, a €0.50 charge per prescription item will apply for medical card holders (max €10 per month per family).
Restrictions will also be imposed on entitlements of medical card holders to dental treatment from dentists in private practice.
• Drug Refund: A family can get a refund on the cost of prescribed drugs used in any month in excess of €120
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.
• 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 Outpatient €100 unless referred by your doctor or admitted to hospital
• Public Ward Bed €75 per night (up to a max. €750 in a year)
• Private patients pay €795 per night (semi-private), €984.60 (private), €727.80 (day care).
• Waiting TIme: Public patients who have been listed by a consultant for a procedure, are entitled after three
months waiting, to have the treatment arranged privately by the National Treatment Purchase Fund. You
can contact themyourself or be referred by your GP or consultant (Locall: 1890 720 820). You will be informed of the
proposed consultant and hospital for your approval before treatment will be arranged. The maximum wait after contacting
the NTPF is three months.
• Nursing Home Support: Since 27th October 2009 the new scheme “Fair Deal” has come into force. New
patients seeking a place in either a Private or a Public Nursing Home now have the same assessment of need and the same
means-test for payment. The patient will be liable to pay towards the cost of care:
• 80% of assessible income (i.e. after deduction of tax, PRSI, mortgage/rent and out-of-pocket medical expenses)
• plus 5% of the value of any assets, in excess of a disregard of €36,000
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 only, the deferred contribution will be
capped at 15% (i.e. after three years of care). The deferred charge against the home will not be collected during the life time
of a surviving spouse or a disabled child. This deferral must be separately requested by the patient, or by a care
representative approved by the Circuit Court for a patient who is not capable of making the decision themselves.
• HOME CARE PACKAGE: A Home Care Package can fund a care plan in the home, where the need is assessed on discharge from hospital, or by the Public Health Nurse to keep a person out of institutional care. The HSE will fund the full cost where the patient’s income is no more than €100 in excess of the Contributory Old Age Pension. The HSE contribution is reduced by income in excess of that limit.
• CARERS ALLOWANCE: A person who is living with, (or close by with a direct communication system), and giving full-time care to a child on Domiciliary Care Allowance, or to any person aged 16 or over requiring full-time care, can apply for a means-tested
weekly Carers Allowance of €220.50 (€239 if carer is 66 or over) plus an annual €1,700 Respite Grant.
In the means-test, any weekly income of the carer in excess of €332.50 (single), or half of their own and their spouse’s
income in excess of €665 (married) is assessed. The allowance is reduced accordingly, disregarding the fi rst €7.60.
Half rate Carers Allowance is payable to persons receiving another Social Welfare Payment.
An additional 50% allowance and full respite grant will be paid to a person caring for more than one incapacitated person. Carers
are entitled to free travel in their own right and to free telephone rental, free TV licence and free electricity.
A carer can take up training or paid employment for up to 15 hours per week. Carers are entitled to credited
contributions to keep you in benefi t. When you cease caring, you are entitled to go on Back to Work, Back to Education or
Community Employment Schemes.
Persons caring full time can qualify for €1,700 Respite Grant regardless of means but persons working over 15 hours or
on Jobseaker payments will not qualify.
A Carers Benefi t of €221.20 based on your Social Insurance can be claimed for short-term absences from work (up to 24 months) for caring responsibilities. It is available to all insurance classes except S and J. Limited work earning up to €332.50 per week is permissible, while claiming this benefi t. Your job is protected for the 24 month duration.
A Mobility Allowance of €202.00 per month is payable by the HSE to a person (aged 16-66) who is unable to walk, if their income does not exceed Social Welfare Contributory Pension by more than €12.70 per week.