Living in Ireland
As an American visiting or residing in Ireland, there is certain pertinent information surrounding the issue of medical care that you must be aware of:
The Republic of Ireland provides certain types of medical care to people deemed “ordinarily resident” in the country free of charge. If you reside in Northern Ireland, visit the U.S. Consulate General, Belfast, website for information regarding medical services in Northern Ireland.
One’s categorization as “ordinarily resident” and “not ordinarily resident” is determined by whether or not one intends to reside in Ireland for one year or more; those planning on staying for a year+ are typically considered ordinarily resident. Various types of evidence may be requested and the following are acceptable forms of evidence:
- A work permit or visa, a statement from your employer or a contract of employment;
- Proof of purchase of a property or property rental (i.e., a lease), including evidence that the property in question is your main residence - evidence of transfer of funds, bank accounts, pensions;
- An Alien's Registration Book (Green Book), residence permit as stamped on your passport.
For more information on distinctions and determinations of “ordinarily resident” and “not ordinarily resident" visit the Heath
Service Executive (HSE) website.
* It is important to note that the Irish government makes all final decisions on medical benefits eligibility—no one should presume they are entitled to any benefits without confirmation from the appropriate authorities.
- Visitors, or those staying for less than a year are sometimes entitled to free or reduced cost services based on a means test—meaning that one’s income would need to fall below a certain level to be entitled to free or reduced service.
- Of those who are determined to be ordinarily resident, a second determination is made between “medical card holders” and “non medical card holders”. Eligibility for a medical card is also determined by a means test. Those who are Irish citizens or are “ordinarily resident” are welcome to apply for a medical card if they think their income meets the requirements.
- Those with medical cards receive nearly all medical care for free, while those without medical cards are: “entitled to free public hospital services but may have to pay in-patient and out-patient hospital charges. They are also entitled to subsidised prescription drugs, medicines and maternity and infant care services and may be entitled to free or subsidised community care and personal social services. They are not entitled to free GP services. They may be entitled to some community care and personal social services.”
- In addition, there are some exceptions to medical cards being the determinant of services provided on a free or fee paying basis:
1) People suffering from certain illnesses may qualify for free prescribed drugs and medicines regardless of their medical card status.
2) Child health services are available to all children.
3) Health promotion is aimed at the entire population.
- Unlike the US, Ireland has three types of hospitals. If one is deemed to be “not ordinarily resident” the Health Board may apply the full economic charge for any services provided or provide urgent necessary treatment at a reduced charge or without charge (as deemed appropriate by the board) where application of the full economic charge would cause undue hardship. These fees are charged at the full rate regardless of what type of hospital one attends, i.e., whether or not one is occupying a private or public bed.
1) Health Service Executive hospitals; owned and funded by the Health Service Executive Voluntary—they are public hospitals, most of whose income comes directly from the government.
2) Voluntary public hospitals; sometimes owned by private bodies, i.e., religious orders. Other voluntary public hospitals are incorporated by charter or statute and are run by boards often appointed by the Minister for Health and Children.
3) Private hospitals; receive no state funding and thus normally require some type of private insurance. In addition to the multitude of American providers that will cover one internationally, a number of companies offer voluntary private health insurance in Ireland. The Citizens Information website provides detailed information about private health insurance in Ireland.
- Everyone living in the country and certain visitors to Ireland are entitled to free maintenance and treatment in public beds in Health Service Executive and voluntary hospitals. Some people may have to pay some hospital charges. Out-patient services in public hospitals are also free of charge but some people may have to pay an initial charge if they have not been referred by a GP.
- If you are in a private hospital or in a private bed in a public hospital, you must pay for both maintenance and treatment. Your private health insurance may cover some or all of the costs. It is important to note, that an American traveler or resident in Ireland should always have private health insurance that will sufficiently cover them both in Ireland and in the United States. Medicare benefits are never available to citizens overseas.
- The Embassy recommends that all Americans traveling overseas consider a travel insurance policy to cover unexpected illness, injury or other circumstances adversely affecting their travel. The cost of medical care overseas can be considerable, as well as the costs of returning home with an illness or injury, and unless the traveler has adequate insurance they themselves must cover all costs incurred. If you require more information about travel insurance, please consult with a travel professional.
Please use this link on the US Department of State Bureau of Consular Affairs website for an
extensive listing of Foreign and US-based Travel Medical Insurance Providers.
Please use this link for Foreign and US-Based Air Ambulances/Med Evac/Executive Medical Services/Medical Escort Providers.
For more detailed information about public services and entitlements in Ireland, visit the Irish Citizens Information website, (Online Access to Services, Information and Support) an Irish eGovernment website).