Regulation (EC) 883/2004, and Implementing Regulation 987/2009, provide for the coordination of social security systems, including health care, within the EU/EAA and Switzerland. Under its provisions, persons residing in Ireland who are attached to the social security system of another member state are entitled to receive health care services in Ireland at the cost of that member state, provided they are not subject to Irish social security legislation. Persons in this category are entitled to full eligibility and a medical card on the basis of EU Regulations as evidence of their entitlement. However, like all medical card holders, they will be subject to the prescription charge of €2.50 for each item that is dispensed under the medical card scheme, up to a maximum of €25 per month per person or family.
Ireland operates a bilateral health care reimbursement agreement with the United Kingdom, in respect of health services provided under EU Regulations, covering such persons as temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and the dependant families of persons employed in the other country. Under the terms of the agreement net liability between the two countries is calculated on a lump sum basis rather than an individual basis. The payment made in any one year is based on an estimate of the number of persons falling within categories eligible for reimbursement and for whom each country is liable and an estimate of the average cost of providing health care treatment. An amount of €220 million was received from the United Kingdom in 2013. The payments are received by the Health Service Executive as Appropriations-in-Aid and are offset against the gross funding requirements of the Executive at national level thus reducing the net liability to the Exchequer.
