Income and expenses guidelines for a Medical Card or GP Visit Card

This page explains how the HSE works out your means test for a medical card or GP visit card based on your income and expenses.

Use this topic if you or someone you support:

• Want to sense check your own financial situation and determine whether you might be eligible for a medical card or GP visit card.
• Prepare for a conversation with the HSE, Citizens Information, or your GP.

Note

This page offers plain language guidance. It is not a legal document.
Only the HSE can make an official decision about a Medical Card or GP Visit Card.

1. How the HSE works out your means test

When you apply, the HSE looks at:

1. Your household income after tax, PRSI and USC.
2. Any allowable expenses.
3. The size and type of your household.

They divide income into two groups:

• Assessable income, which is counted in the means test.
• Non assessable income, which is ignored in the means test.

Your qualifying financial threshold is:

• basic rate for your household
• plus amounts for each dependent child
• plus allowable expenses

If your net weekly income is below this figure, you should qualify for a Medical Card.
If you are above the limit for a Medical Card but still within the guideline for a GP Visit Card, you may get a GP Visit Card instead.

If all of your income is from social welfare or HSE allowances, you get a Medical Card even if you are above the financial guidelines.

Important

The figures below are taken from the HSE national assessment guidelines at the time of writing.
Always check the official HSE site if you need the latest rates.

Open the sections for the details that matter to you.

1. Weekly income limits if you are under 70

If you, or your spouse or partner, are under 70 years of age, these are net weekly income limits, after tax, PRSI and USC.

These limits apply before adding amounts for dependent children and allowable expenses.

2.1 Single person living alone. Under 70.

If your income is at or below the figure in your row, you may fit the usual guideline for that card type.

Age band	Medical Card limit	GP Visit Card limit
Under 66	€184.00	Not available
66 to 69	€201.50	Not available
Up to 69	Not available	€418.00

2.2 Single person living with family, under 70

If your income is at or below the figure in your row, you may fit the usual guideline for that card type.

Age band	Medical Card limit	GP Visit Card limit
Under 66	€164.00	Not available
66 or over but under 70	€173.50	Not available
Up to 69	Not available	€373.00

2.3 Couple or one parent family with dependent children, under 70

If your income is at or below the figure in your row, you may fit the usual guideline for that card type.

Age band of main applicant	Medical Card limit	GP Visit Card limit
Under 66	€266.50	Not available
66 or over but under 70	€298.00	Not available
Up to 69	Not available	€607.00

2. Income limits if someone in your household is 70 or over. Gross Income Scheme.

If you, or your spouse or partner, are 70 or over, higher income limits apply. For these cases, the HSE uses a Gross Income Scheme, which looks at your income before tax and deductions.

• Single person aged 70 or over

  • If your gross weekly income is €550 or less, you qualify for a Medical Card.
  • If your gross income is over €550, you qualify for a universal GP Visit Card.

• Married or co habiting couple where at least one person is 70 or over

  • If your combined gross weekly income is €1,050 or less, you both qualify for a Medical Card.
  • If your combined gross income is over €1,050, you both qualify for universal GP Visit Cards.

These limits are set nationally.
If your weekly assessable income is under these higher limits, the HSE generally grants a medical card without looking at detailed expenses, once residency and other conditions are satisfied.

Note

For this scheme, gross income means income before tax or deductions.
It includes pensions, earnings, savings income and rental income, with normal expenses allowed off the rent.

Savings and investments up to €36,000 for a single person or €72,000 for a couple are ignored in this scheme. Above these amounts, savings are still assessed using the rules in section 6.

3. Amounts for dependent children

If you have dependent children, the HSE can add extra amounts to your income limit.

A child is usually treated as dependent if:

• They are under a certain age, or
• They are in full time education, or
• They have a disability and rely on you for support.

For each dependent child, the HSE can add an extra weekly amount to your income limit.
This makes it easier for families with children to meet the income test.

If you have dependent children, extra amounts are added to your income guideline.

Dependent child type	Medical Card addition per child per week	GP Visit Card addition per child per week
First two children under 16	€38.00	€57.00
Third and later children under 16	€41.00	€61.50
First two children over 16	€39.00	€58.50
Third and later children over 16	€42.50	€64.00
Dependent over 16 in full time third level with no grant	€78.00	€117.00

These amounts are added to the basic rate for your household before the HSE compares your income with the guideline.

4. Assessable income

The following are usually counted as assessable income.

Work and pensions

• Wages and salary
• Income from self employment
• Occupational and private pensions
• Fees and commissions
• Payments for holding an office or directorship
• Royalties and annuities

Property and investments

• Payments under a settlement, covenant or from an estate
• Rental income from property other than the family home
• The value of property, other than the family home, that could be leased or sold
• Savings and investment income

Social welfare and maintenance

• Social security payments from outside the EU
• Some social welfare payments (see next section)
• Maintenance payments received
• Some scholarships and stipends above the exempt limit

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4.1 Social welfare payments that may be assessed if you have other income

If you have other income as well as social welfare, some of those payments can also be counted.

Examples include:

• Jobseeker’s Allowance and Jobseeker’s Benefit
• State Pension contributory and non contributory
• Disability Allowance, Illness Benefit and Invalidity Pension
• One Parent Family Payment
• Widows, widowers and surviving civil partner pensions
• Maternity Benefit, Paternity Benefit and similar payments

The full guidelines contain the complete list.

Important

If all of your income is from social welfare or HSE payments only, you can qualify for a Medical Card even if you are above the normal limit.

5. Income that is not assessed

Some types of income are ignored or only partly counted in the means test.

Examples include:

• Certain social welfare payments that are specifically disregarded in the guidelines.
• Small earnings from limited work schemes or training programmes.
• Certain carer related payments in specific circumstances.

The detailed HSE guidelines list each payment and whether it is counted, partly counted or ignored.
If you have a payment you are unsure about, it is worth checking with Citizens Information or the HSE.

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The lists below highlight common examples. They are not a full legal list.

5.1 Compensation awards that are not assessed

Examples include:

• Hepatitis C compensation tribunal awards and income from investing that compensation
• Residential Institutions Redress Board awards
• Certain repayments under the Health Repayment Scheme
• Awards under the Redress for Women in Certain Institutions Act
• Other specific state redress schemes listed by the HSE

5.2 Social welfare and state payments that are not assessed

Examples include:

• Child Benefit
• Carer’s Allowance and Carer’s Support Grant
• Domiciliary Care Allowance
• Working Family Payment
• Blind Welfare Allowance
• Fuel Allowance
• Foster Care Allowance
• Guardian’s payments
• Living Alone Increase and Over 80 Allowance
• Supplementary Welfare Allowance
• Some education grants and certain aftercare allowances
• Educational stipend for people on Disability Allowance, up to €20,000 per year for four years

5.3 Rental income that is not assessed

• Accommodation Recognition Payment for hosting people from Ukraine
• Rent a Room income in your home, up to €14,000 per year

If you receive another payment or are unsure whether a payment or income type is counted, you can contact the National Medical Card Unit.

6. How savings and investments are assessed

The HSE also looks at savings and property where relevant.

• Savings and investments in banks, credit unions or post office accounts.
• Shares or other investments.
• Additional property apart from the home you normally live in.

They usually ignore your main home.
For savings and investments above a certain amount, the HSE may treat part of them as weekly income and include this in your means test.

If you have a second property, the HSE may look at its value or at any rental income.

You can provide either:

• a certificate of interest covering all accounts, or
• recent statements showing current balances.

The HSE converts your savings into a weekly income value using this scale.

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6.1 Single person

Total value of savings and investments	Weekly amount counted
Up to €36,000	None
€36,001 to €46,000	€1 for each €1,000 over €36,000
€46,001 to €56,000	€2 for each €1,000 in this band
Over €56,000	€4 for each €1,000 above €56,000

6.2 Couple

Total value of savings and investments	Weekly amount counted
Up to €72,000	None
€72,001 to €82,000	€1 for each €1,000 over €72,000
€82,001 to €92,000	€2 for each €1,000 in this band
Over €92,000	€4 for each €1,000 above €92,000

These scales are used whether your savings are in one account or spread across a number of accounts.

If you have both savings and another property, the non-assessable allowance is only taken off once. Not once for each type of asset.

In both tables, only the amount over the allowance is converted into a weekly income amount.

7. How the HSE looks at property other than your home

This section is about property apart from your main home. For example, a second house or a piece of land. If you own property apart from your main home, the HSE assesses a weekly income from it.

The HSE may ask for proof of the property’s value or rental income. For example:

• If the property is rented out

  • You must provide a tenancy agreement and evidence of recent rental income.

• If the property is not rented out

  • You must provide a professional valuation, and the HSE assesses the value under the same bands as savings and investments.

• If you have both savings and another property

  • The non assessable allowance is only taken off once across both.

8. Allowable expenses

The HSE can subtract some regular costs from your income before they compare it with the guideline. This can bring you closer to qualifying.

Typical allowable expenses include:

• Housing costs
  • Part of your rent or mortgage, up to a set limit.
  • Mortgage protection and life assurance related to the mortgage
• Health costs
  • Regular expenses such as prescribed medicines or medical appliances that are not fully covered by schemes.
• Nursing home, private nursing or home care costs for you or your spouse
• Childcare or care costs
  • Some costs for childcare or care of a dependent person, where needed so that you or a partner can work or study.
• Maintenance payments that you pay to someone else
• Travel to work costs, including public transport, driving and reasonable carpooling contributions

You may need to provide evidence, such as receipts, statements or a letter from a health professional.

Examples of evidence they might ask for:

• tenancy agreement or rent statement
• mortgage statement, tax relief details, and mortgage protection letters
• home insurance certificate or bank statements showing payments
• letters from childcare providers, maintenance agreements, or nursing homes
• vehicle registration details and information about distance travelled to work

Only reasonable, everyday amounts are allowed, not luxury or one-off costs. Any HAP (Housing Assistance Payment) is deducted from rent when working out allowable rent.

9. Self employment and other complex income

This section is for people who are self employed or have small business income. For self employed people, the HSE normally uses your Notice of Assessment or Form 11 details from Revenue.

They will:

1. Look at your gross business income.
2. Deduct tax, PRSI and USC.
3. Deduct trade capital allowances and eligible business expenses.
4. Divide the result by 52 to get a weekly income.

If your business has been open less than a year, or if it has recently closed, they may use signed accounts from your accountant instead.

If you have other small sources of income that are not listed, and they add up to less than a set yearly amount, the HSE guidelines may ask for a Revenue statement such as a P21 or end of year statement instead.

10. If your income is above the guideline

If your income is over the usual guideline, the HSE can still look at your situation in more detail before they decide. They can still award a Medical Card or GP Visit Card on discretionary grounds.

They may look at:

• your medical conditions or those of your dependants
• how often you need GP or hospital care
• your medication and medical appliance costs
• other health related expenses
• any recent changes in income or outgoings
• other serious financial pressures that are not obvious from the figures alone

You may need to send medical reports and receipts so that a medical officer can review your case.

11. Medical cards under EU Regulations

EU social security rules can sometimes give you a right to public health services in Ireland because you are insured in another EU or EEA country, Switzerland or the UK.

This route is handled using EU Regulations, not the standard Irish means test.
The HSE looks mainly at:

• where you are insured for social security,
• where you live, and
• whether you are a worker, pensioner or dependant.

You usually need to send EU forms from the country that insures you, for example an S1 form.

13.1 If you work in another EU or EEA country but live in Ireland

You may be treated as a frontier worker. A frontier worker is someone who lives in one country but regularly travels to work in another country and normally goes back home at least once a week.

This may apply if:

• you live in Ireland,
• you work in another EU or EEA country, Switzerland or the UK, and
• you pay social insurance there.

In many cases: - your day-to-day healthcare is provided in the country where you work, and
- you and your dependants may also be able to get health services in Ireland, paid for by the other country.

The other country usually sends an S1 form (or similar EU form) to the HSE.
Once this is registered, the HSE can tell you what services you and your dependants can use in Ireland. In some cases this gives you the same practical cover as a Medical Card or GP Visit Card, even though the decision is based on EU rules rather than the usual income limit.

What the HSE may check

• Where you normally live and where you work.
• Which country is responsible for your social insurance.
• EU forms such as S1 that show who should pay for your care.

13.2 If you get a pension from another EU or EEA country, Switzerland or the UK

EU rules can apply if:

• you live in Ireland, and
• you receive a state pension from another EU or EEA country, Switzerland or the UK, with or without an Irish pension.

Depending on your insurance history, that other country may be responsible for your healthcare. In that case it can:

• send an S1 form to the HSE, and
• pay the cost of certain health services you receive in Ireland.

If EU Regulations apply, the HSE will explain:

• whether you get the same benefits as a Medical Card or GP Visit Card holder, and
• whether any Irish means test is still needed.

What the HSE may check

• Which countries you get pensions from.
• Your social insurance record in each country.
• EU forms sent by the pension country, for example an S1 form showing that it is responsible for your healthcare.

13.3 If you are a dependant of someone insured in another EU or EEA country

You may be treated as a dependant under EU Regulations if:

• you live in Ireland, and
• your spouse, civil partner, parent or another family member is insured for healthcare in another EU or EEA country, Switzerland or the UK.

Examples include:

• a spouse or partner who works in another EU country while the family lives in Ireland,
• children living in Ireland where a parent is insured for healthcare in another EU state, or
• certain other family members who rely financially on an EU-insured worker or pensioner.

In these cases, the country that insures your family member may also be responsible for your healthcare in Ireland. It can send an S1 form to register you as a dependant.

What the HSE may check

• Your relationship to the worker or pensioner.
• Where each person lives.
• Evidence that you are treated as a dependant under that country’s rules.
• The EU forms sent on your behalf.

13.4 Documents and evidence for EU Regulation cases

For EU Regulation cases, the HSE usually asks for:

• EU forms such as S1 from the country that insures you or your family member,
• proof of where you and your family live,
• pension or employment details from the other country, and
• any other documents listed in the HSE or Citizens Information guidance for EU Regulation medical cards.

If you think EU rules might apply to you, it can help to:

• contact the health insurance or social security office in the other country and ask how to get an S1 form,
• keep copies of all letters or forms, and
• bring these when you contact Citizens Information or the National Medical Card Unit.

11. How the HSE uses this information in practice

This is roughly what happens behind the scenes if you decide to apply after using this checker.

When you apply, the HSE will:

1. Identify which household type and age band applies to you.
2. Add up your total weekly income.
3. Subtract any allowable expenses you have shown evidence for.
4. Add any assessed income from savings or property if needed.

5. Compare the result with the income limit for your household type.

6. If your assessable income is below or close to the limit, you may qualify for a medical card.

7. If your income is above the limit, you may still qualify for a GP visit card or you can ask for a review if there are special circumstances, such as very high medical costs.

You can print this page or bring it on a phone or tablet to talk it through with a GP, Citizens Information or a community worker.

12. Where to get more help

You do not have to figure this out on your own.

• You can apply online using the official HSE medical card website, or use the postal forms if you prefer.
• You can contact the National Medical Card Unit if you are unsure how a particular income or expense will be treated.
• You can bring a copy of this page to Citizens Information, your GP or a community worker if you want help talking through your situation.