The Long-Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme.
These 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; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
Statutory Instrument No. 277 of 1971, put a limitation on Section 59(3) of the Health Act 1970, in respect of the provision of medicines to those suffering from mental illness:
"Arrangements for the supply of drugs and medicines to persons suffering from mental illness in pursuance of section 59 (3) of the Act shall be made only in respect of persons under the age of 16 years."
Therefore, the limitation on age currently applies to persons eligible for the LTI Scheme under the category of "mental illness"; the Scheme has operated on this basis since its inception.
However, it is important to remember that the LTI Scheme exists within a wider eligibility framework. This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility in line with the vision, aims and objectives of Sláintecare.
In 2022, a range of measures were delivered including the abolition of public inpatient charges for children, reductions in the Drug Payment Scheme threshold to €80 per month, and the introduction of free contraception for women aged 17-25.
Additional measures in 2023 continued to expand eligibility. These included an expansion of GP care without charges to children aged 6 and 7, and to people earning no more than the median household income, the abolition of all public in-patient hospital charges for adults, and the extension of the free contraception scheme to include women aged 26-30.
These measures continue to create a health and social care service that offers affordable access to quality healthcare.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
