The Health Act 1970 (as amended) provides for two categories of eligibility for all persons ordinarily resident in the country, i.e. full eligibility or limited eligibility for health services. Persons with full eligibility (medical card holders) are entitled to a range of services including general practitioner services, prescribed drugs and medicines, all in-patient public hospital services in public wards including consultant services, all out-patient public hospital services including consultant services, dental, ophthalmic and aural services and appliances and maternity and infant care services. People with limited eligibility (non-medical card holders) are entitled, subject to certain charges, to all in-patient public hospital services in public wards including consultant services and out-patient public hospital services including consultant services.
Separate to the public health system, my Department oversees the maintenance of a competitive and sustainable private health insurance market, under the provisions of the Health Insurance Acts 1994 to 2014, and monitors developments on an ongoing basis to ensure that the market is regulated appropriately. The policy objective of introducing Lifetime Community Rating (LCR) to the health insurance market is to encourage people to purchase health insurance at a younger age, as community-rated markets depend on a continuing influx of younger people to help spread the costs of older and less healthy people across the market and helping to support affordable community-rated premiums for everyone who wishes to purchase insurance.
It is important to note that the purchase of private health insurance is optional. The regulatory framework governing health insurance, such as late entry loadings under LCR, applies to all persons choosing to purchase health insurance and is not related to a person's eligibility, or previous eligibility, for public health services. People who do not take out health insurance continue to have the same entitlement to services in the public hospital system.
