Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Health Act 1970 (as amended) provides for two categories of eligibility for persons ordinarily resident in the country, i.e. full eligibility (medical card holders) and limited eligibility (all others). Adults with full eligibility can access a range of services including GP services, prescribed drugs and medicines, all in-patient public hospital services in public wards, including consultants’ services, all out-patient public hospital services including consultants’ services, dental, ophthalmic, and aural services and appliances, and maternity and infant care service.
Persons with limited eligibility are eligible for acute public in-patient hospital services in public hospitals and outpatient public hospital services including consultant services, Emergency Department, or minor injury care, are subject to certain charges. Other services such as allied healthcare professional services may also be made available to persons with limited eligibility.
Private health insurance in Ireland is regulated under the Health Insurance Acts (1994 -2022). The Irish market is a voluntary private health insurance market for those who are ordinarily resident in Ireland. The Irish market operates under four key principles – community rating, open enrolment, lifetime cover and minimum benefits. It is not compulsory for anyone to buy private health insurance in Ireland. More information on the policies and type of cover available can be found on the Health Insurance Authority’s website. www.hia.ie
Illness Benefit is a legislative scheme in Ireland which is funded through PRSI (Pay-Related Social Insurance) contributions that are deducted at source from the salaries of employees along with contributions from employers.
The scheme is currently legislated for under: • Part 2 - Chapter 8 (Sections 40 to 46) of the Social Welfare (Consolidation) Act 2005 Number 26 of 2005, as amended And • Part 2 - Chapter 1 (Articles 20 to 28) of Social Welfare (Consolidated Claims Payments and Control) Regulations, 2007 (S.I. no. 142 of 2007) as amended Illness Benefit is an insured income support provided to those who are certified as being unable to work due to illness of any kind in the first instance.
There are other illness related payments that are provided for through either PRSI or through direct welfare provision, but Illness Benefit is specifically for those who become ill and are insured through PRSI contributions made while in employment.
The range of illness related supports provided by the Department of Social Protection can be found in the following publication "Your Guide to our Schemes and Services: Illness, Disability and Caring" (August 2022). It is currently available at the following web address: www.gov.ie/en/publication/5b72a-illness-disability-and-carer
