The Health Service Executive (HSE) has statutory responsibility for reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
The Long Term Illness scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made prescribing 16 illnesses covered by the scheme, including diabetes. Under the scheme, patients receive medicines and medical appliances related to the treatment of their illness, free of charge. However, as gestational diabetes is not a permanent or long-term illness it is not included in the scheme.
Budget 2023 provided funding for several new initiatives aimed at improving diabetes care, including the provision of glucose testing strips without charge to women affected by gestational diabetes. The Department and the HSE are working to deliver this as soon as possible.
These items are currently reimbursable under the Drug Payment Scheme and to medical card holders, subject to the relevant co-payment.
Under the Drug Payment Scheme, no family pays more than €80 a month towards the cost of approved prescribed medicines.
The HSE may grant a medical card even where a person exceeds the income guidelines, if they are in difficult financial circumstances, such as having extra costs arising from illness.
People may also be entitled to claim tax relief, at the standard rate, on the cost of their medical expenses.