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Apply for a Medical Card or GP Visit Card on hardship or medical grounds

This topic helps you if your income is above the normal limits, but you think that medical expenses or financial hardship mean you still need a Medical Card or GP Visit Card.

Use this topic if you or someone you support is
  • Struggling to pay ongoing medical costs, for example medication, GP visits, hospital appointments or medical equipment
  • Experiencing undue financial hardship, even if income is just above the usual guideline limits
  • Caring for a family member whose illness or disability creates extra costs, for example travel to treatment, special diet or care costs
  • Applying for a Medical Card or GP Visit Card and want the HSE to look beyond income alone and consider your overall circumstances

If you are not sure this is the right route, you can also look at:

  • Check if you can get a Medical Card or GP Visit Card
  • Other ways you might qualify for a Medical Card or GP Visit Card

Note

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

Steps

Step 1. Decide whether hardship or medical grounds might apply to you

You can use this step if:

  • Your income is above the normal guideline limits, or
  • Your situation is not fully captured by income alone

Typical situations include:

  • You or someone in your household has a serious or long term illness with regular costs
  • You have disability related expenses, for example extra heating, special diet or equipment
  • You recently had a big change in circumstances, for example bereavement, job loss, separation or sudden illness
  • You are paying off necessary debts, for example mortgage arrears or utilities, and there is very little left after essential costs

If you recognise yourself in any of these examples, you can ask the HSE to:

  • Assess your application on hardship or medical grounds, and
  • Look at your overall financial and medical situation, not just income
Step 2. Show the HSE that you are applying on hardship or medical grounds

You usually use the same main application forms as everyone else:

  • MC1. if you are under 70
  • MC1a. if you are 70 or over

When you are filling in the form or online application:

  • Complete all income and household sections as normal
  • Use any “Additional information” or “Extra notes” space to write that you are asking for a Medical Card or GP Visit Card on:
  • Medical grounds,
  • Hardship grounds,
  • Or both, if that is your situation

If there is no clear space on the form, you can:

  • Attach a short cover letter headed “Application on hardship and or medical grounds”
  • In your letter, briefly explain:
  • Your main medical conditions and ongoing costs
  • Any other reasons why it would be unduly difficult for you to pay for healthcare yourself

You can also:

  • Ask a medical social worker or other key worker to write a supporting letter
  • Mention on the form that you have enclosed this letter

The HSE will use this information to decide whether a discretionary Medical Card or GP Visit Card can be given based on your overall circumstances.

Step 3. Gather evidence of financial hardship

The HSE must look at both income and reasonable expenses when they assess hardship cases. To help them see the full picture, it can be useful to prepare:

  • A simple household budget, showing for each month:
  • All sources of income

  • Essential outgoings, for example:

    • Rent or mortgage
    • Utilities and home heating
    • Food and basic household costs
    • Transport to work, education or health appointments
    • Childcare or care costs

  • Proof of these outgoings, for example:

  • Recent rent or mortgage statements
  • Recent utility bills
  • Receipts or statements for travel costs to health appointments
  • Letters or statements about loan repayments or agreed arrears plans

You do not have to use complex formats. Plain lists or simple tables are enough as long as they are clear and honest.

Step 4. Gather medical information to support your case

If you are applying on medical grounds, or medical costs are a big part of your hardship, the HSE may look for evidence that your condition:

  • Is ongoing or long term, and
  • Creates extra health related costs for you or your family

Useful documents include:

  • A letter from your GP or consultant that:
  • Names your main medical conditions
  • Says whether they are long term or ongoing
  • Lists any treatments or regular appointments you need

  • Mentions if you would find it hard to manage without a Medical Card

  • A list of regular medical expenses, such as:

  • Average monthly prescription costs
  • How often you see your GP or other health professionals

  • Any hospital charges, therapy costs or clinic fees

  • Details of:

  • Medical equipment or supplies you must buy, for example dressings, continence products, supports
  • Any special diet or extra heating recommended because of your condition

Where possible:

  • Keep receipts or pharmacy printouts for at least the last few months
  • Group costs so it is easy for the HSE to see how quickly they add up over a year
Step 5. Apply, or ask for a review of a decision

You can use hardship or medical grounds in two main ways:

A. When you first apply

  • Complete your application online or by paper form as normal
  • Make sure you clearly say that you are asking for a Medical Card or GP Visit Card on hardship or medical grounds
  • Attach or upload:
  • Your budget and income information
  • Any medical letters
  • Copies of bills and receipts that show your extra costs

B. If you were refused a card based on income

If you have already applied and received a refusal letter because your income is above the guideline:

  1. Read the decision letter carefully
  2. Follow the instructions on how to ask for a review or appeal
  3. Send:
  4. A short cover letter explaining that you want your case looked at on hardship and or medical grounds
  5. Any new information about your medical situation or costs
  6. Any updated financial information, for example recent bills or a change in income

You can ask a:

  • Citizens Information Centre, or
  • Medical social worker or Local Health Office

to help you put this information together and make sure nothing important is left out.

What to do next

When you are ready:

  • Decide whether you will apply:
  • Online using the HSE’s Medical Card or GP Visit Card service, or

  • By post using MC1 (under 70) or MC1a (70 or over)

  • Follow the detailed guidance in:

  • Apply online for a Medical Card or GP Visit Card
  • Apply by post for a Medical Card or GP Visit Card (Form MC1)
  • Apply if you are aged 70 or over (Form MC1a)

If at any point you are unsure:

  • Write down your questions and
  • Bring them to Citizens Information, or
  • Phone your Local Health Office and ask to speak to someone about Medical Cards on hardship or medical grounds

You are not expected to know all of the rules yourself. HSE staff and Citizens Information deal with these cases every day and can help you decide the best way to present your situation.