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Cutting your healthcare costs: what State supports are available?

On The Money: Various supports could help consumers reduce medical bills this year, especially for children and older people

Changes to schemes helping defray healthcare costs will benefit consumers this year. Photograph: iStock

Dominic Coyle's face
Dominic Coyle
Fri Feb 10 2023 - 15:27

Welcome to this week’s On The Money newsletter. With much of the State still in the grip of various winter bugs as well as a resurgent Covid, medical bills can mount up pretty quickly, especially with private GP visits costing €60 a time or more.

But with the Government investing heavily in measures that are seen to help people address in part the financial pressures of the rising cost of living, it’s worth checking whether you might be entitled to some relief from those costs. Some of these reliefs are long-standing and familiar to many of us, but there are a number of changes coming this year that will broaden access and reduce family healthcare bills.

As a policy, the Government has been extending free GP care to younger children. As of now, any child under the age of six is entitled to be seen without charge by a GP. The scheme was due to be extended to children aged six and seven by the end of last year. That has been delayed but should materialise in the coming months.

Any Irish resident adult over the age of 70 is also entitled to a free GP care card, regardless of their income. This is of use particularly to those older people who do not qualify for a full medical card.

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For anyone else, there is a means test to decide on eligibility. However, the Government stated in Budget 2023 that, from April 1st of this year, anyone earning the median household income – €46,000 – or less will be eligible for a free GP card.

With children and older people the most common users of GP services, the free GP care scheme can be extremely valuable in ensuring timely access to medical treatment where it is needed, without having to worry about cost.

The one downside is that you may have to change GP in order to access the free GP care for your child if your current doctor’s practice is so overwhelmed that it is not accepting new applications. This is unfortunate as the relationship between a GP and a patient/parent is a personal one. Doctors and the health authorities are currently in discussion about the situation in advance of the next expansion of the scheme, which is eventually expected to provide free care for all children up to the age of 12.

The free GP card does not cover hospital admissions. At present, you can expect to pay €80 a day for hospital care up to a maximum of €800 per year per person. However, again from April 1st, the Government has committed to doing away with these charges.

Medicine costs

If you are on a medical card, you won’t have to worry about hospital charges or medicine costs but for others the Drugs Payment Scheme puts a monthly cap on the amount you have to pay for medicines.

And this cap has been falling in recent years, from €144 a month back in 2017 to just €80 a month now, which is good news for hard-pressed families with sick children.

You have to apply proactively for this scheme. Most people will have done so but, if not, you should do so right away as the cap covers not just your own medicine costs but those of your family.

Once you are over 18 (or, if in full-time education, over 23) you will need to apply for a card in your own name, with your own personal cap. It’s not something a lot of young people think about but they should.

Finally, some other EU states are more generous in the free public healthcare that they offer. If you are entitled to free medical services in one of these countries and subsequently move to Ireland, you will likely retain that free access to medical care here as long as you are not working and paying PRSI in this State or are in receipt of a welfare payment here, such as an Irish State pension. You may need documentation to back up your claim.

And, of course, at year end, you can still claim for tax relief on medical costs incurred over the year that have not been covered by private health insurance or any of the other support schemes.

Medical expenses are regularly cited as being among the reliefs least claimed by taxpayers who are entitled to money back.

Medical cards

Even wider support is available for those families and individuals who qualify for a medical card. In general, medical card eligibility is determined by a means test but there is considerably more latitude for older people.

A single person over the age of 70 can have assessed weekly means of €550 – or €28,600 a year. For couples, the figure rises to €1,050 a week, or €54,600 a year. And even if only one of you is over 70, the higher limit applies.

Of course, as with all means tests, it does not just consider gross income, but also income from savings and assets over the value of €36,000 for a single person and €72,000 for a couple.

However, applicants have the choice of accepting the HSE’s notional rate of interest on cash savings or submitting a certificate of interest showing details of the actual interest earned in a year, where that figure is lower.

On longer-term savings, or investment locked into fixed rates, the HSE is prepared to wait until the actual interest is paid at the end of the term and consider that figure, if you so choose.

Another interesting and potentially valuable quirk for people over 70 is that the means test will not assume income from a property other than your family home unless it is actually rented out for all or part of the year. So if you have a holiday cottage by the sea and it is only used by you or your family for a break, it will not be taken into account in the means test.

Winter gas bills are now dropping in the door, adding even more pressure to the finances of hard-pressed consumers. Given the variety of health reliefs now on offer, or coming in over the coming months, it makes sense not to assume you must pay the full cost of your family’s healthcare needs. Taking the time to see what benefits you qualify for will pay dividends in the long run.

You can contact us at OnTheMoney@irishtimes.com with personal finance questions you would like to see us address. If you missed last week’s newsletter, you can read it here. Also, to ensure you continue to receive On The Money, be sure to add the email address you receive the newsletter from to your safe senders list