Under the Health Act 1970, a health board may make arrangements for the supply without charge of drugs, medicines and medical and surgical appliances to people suffering from any of the following conditions, who are not already medical card holders, for the treatment of that condition under the long-term illness, LTI, scheme: mental handicap; mental illness, for persons under 16 years only; phenylketonuria; cystic fibrosis; spina bifida; hydrocephalus; diabetes mellitus; diabetes insipidus; haemophilia; cerebral palsy; epilepsy; multiple sclerosis; muscular dystrophies; parkinsonism; thalidomide; and acute leukaemia. Strokes are not included in the list of conditions covered by the LTI.
There is a range of other schemes that provide assistance towards the cost of approved drugs and medicines for people with significant ongoing medical expenses. People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. Eligibility for a medical card is solely a matter for the chief executive officer of the relevant health board. In determining eligibility, the CEO has regard to the applicant's financial circumstances. Health boards use income guidelines to assist in determining eligibility. However, where a person's income exceeds the guidelines, a medical card may be awarded if the CEO considers that the person's medical needs or other circumstances would justify this. Medical cards may also be issued to individual family members on this basis. Non-medical card holders, and people with conditions not covered under the LTI, can use the drugs payment scheme. Under this scheme, no individual or family unit pays more than €78 per calendar month towards the cost of approved prescribed medicines.