In Ireland, when you raise a glass to make a toast with friends, rather than saying “Cheers!”, you would say “Sláinte!”. This is the Irish word for “health” – and as this toast suggests, health and healthcare are big priorities in Ireland. Overall, the Irish health system is safe, modern and efficient. Ireland scores 8.9 on the OECD Better Life Index for health, which indicates strong healthcare and good indicators of everyday health, such as low pollution levels and high-quality water.However, access to healthcare can vary considerably for expats, depending on residency status. In addition, the public health system has downsides, including waiting lists and certain expenses. Understanding the different public and private options available to expats is key to making a happy – and healthy – move to the Republic of Ireland.
Two-Tier System
Ireland has a two-tier health system. That means that permanent residents can choose to use government-funded public healthcare, or to pay extra for private healthcare which operates independently of the state. Many expats are eligible for public healthcare, but it’s important to review all the options before making a decision.
The Public System
The public system has a good reputation for providing high-quality care. However, a hiring embargo means many departments are understaffed, resulting in long waiting lists at A&E and GP clinics, as well as for specialist or long-term care providers. It’s useful to bear in mind that for minor illnesses, waiting times tend to be longest during the winter months, when many hospitals and doctors are busy with cases of influenza and other common health issues.
Eligibility
Expats from the EU or Switzerland have the same rights of access to public healthcare as Irish citizens. Expats from other countries who have habitual resident status can also access the public health system. This status is usually gained by residing and working in Ireland for a year or more. However, certain visas do require expats to have their own medical insurance, rather than relying on the state’s public system. This is often the case with retirement visas for non-EU citizens or with ‘Stamp 0’ visas for temporary stays.
Public Healthcare Costs
Even if you are eligible, public healthcare in Ireland is not always completely free of charge. Depending on your income, age and disability status, both expats and Irish people may have to pay subsidised rates for medical care on the public system. The Health Service Executive will determine whether you are Category One or Category Two. Category One status is typically only granted to those on a low income or for people living with certain kinds of disability – about 30 percent of the population fall into this category. Those in Category One can obtain a medical card which offers totally free access to a range of health services, including GP and public hospital care, dental and optical visits, and some forms of mental health care.
Those in Category Two are entitled to free hospital services, but may have to pay inpatient and outpatient charges. Other services, such as GP and specialist visits, tend to be subsidised rather than being free for residents who do not qualify for a medical card. However, it is possible to qualify for a GP visit card even without the medical card. Maternity care is completely free of charge for all. Without a medical card, you can expect to pay around €100 for a visit to an A&E department, and between €40 and €65 for a GP visit.
Private Healthcare
About 50 percent of Irish residents – and many more expats – opt for private health insurance to avoid waiting lists. There are other benefits, such as private or semi-private accommodation for overnight stays in hospital – staying in a public hospital usually means sharing a ward – as well as cover for additional medical costs such as diagnostic tests and physiotherapy. Remember that your health insurance may not cover the full cost of treatment, and is usually subject to an excess, so do check this carefully.
The major companies offering health insurance in Ireland include VHI (which is part-owned by the Irish government), Aviva, Laya Healthcare and Irish Life Health.
Prices for private health insurance depend on age and prior medical conditions. The Health Insurance Authority website is the statutory regulatory board for the Irish health insurance industry, and can be used to compare policies from different providers. It’s worth noting that private healthcare visits can take place either in private hospitals and clinics, or in public facilities, as some private providers rent space from public hospitals.
Overseas providers of health insurance may not always be accepted for medical care in Ireland, so expats should check whether their home policy will cover them abroad when making a choice.
Pharmacies And Prescriptions
Compared with the rest of Europe, medication is relatively expensive in Ireland, but these costs are beginning to fall thanks to increased competition and more generic drugs on the pharmaceutical market. Expats should note that many medications require a prescription in Ireland, and cannot be sold over the counter at pharmacies. For those with a medical card, or those living with a long-term illness, prescription medications are free of charge. Expats who have habitual residency but do not meet these conditions can apply for the Drugs Payment Scheme, which puts a cap on how much each household spends on prescription medication. This scheme caps medication expenses at €144 per household per calendar month.
There are many pharmacies in Irish towns and cities, but not all towns have 24-hour pharmacies. In general, it’s worth thinking about access to hospitals, doctors and pharmacies when deciding where to live in Ireland, particularly for expats with particular medical needs. In rural areas, there may be some travel involved in medical care, and for specialist treatment you may be referred to hospitals in the nearest town or city.
There’s a lot to think about, but it’s good to have options. Weighing up your medical needs, income, residency status and planned location will allow you to make an informed decision – and by prioritising your health, you’ll be able to make the most of your new life in Ireland.
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