Hse Medical Card And Gp Visit Card Application Form (Page 2 of 12) in pdf

Medical Card and GP Visit Card Form MC1

Help and information

Who can apply for a Medical Card or a GP Visit Card?

What if my household income is over the qualifying

limits?

Anyone who is ‘ordinarily resident’ in the Republic of Ireland

can apply - families, single people, even those working full

If this is the case, you and your family dependants may

or part time. ‘Ordinarily resident’ means that you are living

be granted a Medical Card or a GP Visit Card if you have

here and intend to live here for at least one year.

difficult personal circumstances that cause you financial

pressure - for example a family member with a chronic

I am aged between 16 and 25. How do I apply?

illness. You need to send evidence with your completed

application form in support of these circumstances,

1. If you have a weekly income of less than €164 and

for example, a medical report and or medical expense

you are either living with your parent(s) or living away

receipts.

from their home attending school or college, and your

parent(s) has a Medical Card or a GP Visit Card, you

If I get a Medical Card or a GP Visit Card, does it cover my

must complete Parts 1A, 1C, 1D, 5, and 6 of this form.

family too?

Your doctor of choice must complete Part 6A.

2. If you have a weekly income of less than €164 and

If your family income falls within the qualifying income

you are either living with your parent(s) or living away

limits, the card will cover you, your spouse or partner, and

from their home attending school or college, and your

your children under 16 years of age.

parent(s) don’t have a Medical Card or a GP Visit Card,

your parent(s) must complete all parts of this form.

If your children are aged 16 to 25 and are receiving weekly

3. If you have a weekly income of €164 or more, you must

income less than €164, and living with you or living away from

complete all parts of this form.

you to attend school or college, they will also get a card. They

4. If you live away from your parental home for any reason

must fill out their own application form and send it to us to

other than attending school or college, you must

receive a card.

complete all parts of this form.

How do I qualify for a Medical Card under European

How do I qualify for a Medical Card or a GP Visit Card?

Union (EU) Regulations?

We will look at your household income after tax, PRSI and

You will qualify for a Medical Card under EU Regulations if

the Universal Social Charge (USC) have been deducted. We

you meet all of the following requirements:

also take rent, mortgage, childcare and travel to work costs

•

you are ordinarily resident in the Republic of Ireland,

into account. If the resulting figure is less than the income

•

you are insured under the social security legislation

qualifying limits, you and your family dependants will be

of another EU/EEA member state or Switzerland, that

issued with a card.

means receiving a social security pension from that

state or working and paying social insurance in that

For information on the current income qualifying limits

state, and

that apply to your family size, Callsave 1890 252 919 or

•

you are not subject to Irish social security legislation

see our website

- you are subject to Irish social security legislation if

you are receiving a contributory Irish social welfare

Will my savings and investments be taken into

payment or if you are subject to PRSI in the Irish state.

account when assessing my income for Medical Card or

GP Visit Card eligibility?

If you meet the above requirements, you can claim your

We will not take into account savings or investments of

entitlement to a Medical Card by sending us:

amounts:

•

up to €36,000 for a single person, or

•

a completed application form, and

•

up to €72,000 for a couple.

•

the relevant E or S form issued by the EU/EEA

member state (or Switzerland) you are insured with.

Also, we will not take into account any amount received

from certain state sponsored compensation or redress

UK insured persons applying under EU Regulations should

schemes or any interest earned on the investment of these

send us a letter of confirmation from the UK Pensions

funds.

Board or a recent payslip (if employed in UK) in place of

the E or S form.

For information on the specific compensation or redress

schemes covered by this section, please see

or phone Callsave 1890 252 919.

MC1 May 2015

Hse Medical Card And Gp Visit Card Application Form Page 2

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