Returning from
outside of the UK
Health
Care in Ireland
If you are over 70 years you will be eligible for a
medical
card and free medical care but if you are under 70 years access to
health care will be subject to your income. If your income falls below
the minimum set you will be eligible for a medical card otherwise you
can either purchase medical insurance or, like a large number of people
within Ireland have no medical cover. Prior to moving to Ireland you
should discuss with your current insurance provider the possibility of
having some ‘breathing space’ cover while you sort
out an
alternative. Our information is that no foreign health Insurance
transfers.
How does the Irish
Health Care system work?
Entitlement to health services in Ireland is primarily based on
residency and means rather than income or employment status, and so,
(government argue) the need to
transfer membership from one country's public health insurance system
to another
need not arise. Any person, regardless of nationality, accepted by the
Health Service Executive as being ordinarily resident in Ireland is
entitled to either full eligibility (Category 1, i.e. medical card
holders) or limited eligibility (Category 2) for health services. In
other words, if you come to live in Ireland permanently you are
entitled to use the public health system. The Health Service Executive
(HSE) normally regard a person as "ordinarily resident" in Ireland if
they are satisfiedthat it is their intention to remain in Ireland for a
minimum period of one year.
What is the
difference between Category One and Category Two eligibility?
Persons in Category 1 are medical card holders and they are
entitled to a full range
of services including general practitioner services, prescribed
drugs and medicines, all
in-patient
public hospital services in public wards including
consultants services, all
out-patient public
hospital services including consultants
services, dental, ophthalmic and aural
services and
appliances and a maternity and infant care service.
Persons in Category 2 (non-medical card holders) are entitled,
subject to certain
charges, to all in-patient public hospital services in public wards
including consultants services
and out-patient
public hospital services including consultants
services. There will be a public hospital statutory
in-patient charge per night, with a maximum amount that people
will be charged. Attendance at accident and
emergency
departments is subject to a charge where the patient does not
have a referral note
from his/her doctor (whether or not they have a
medical
card). This charge applies only to the first visit in
any
episode of care. Costs referred to are subject to budgetary changes so
you would need to check these figures with your local H.S.E on
arrival.
What happens if I am
not judged eligible for a medical card?
For those who do not qualify for a full medical card, you may still
qualify for a G.P only medical card (covering the cost of G.P visits
only) as the allowable income level is set at a higher rate.
There are a number of other schemes which provide assistance
towards the cost of medication. Under the
Long-Term
Illness Scheme, persons suffering from a number of conditions
can
obtain, without charge, the drugs and medicines for the
treatment
of the following conditions, mental handicap, mental
illness(for
persons under 16 years only), phenylketonuria, cystic fibrosis, spina
bifida, hydrocephalus, diabetes mellitus, diabetes insipidus,
haemophilia, cerebral palsy,
epilepsy,
multiple sclerosis, muscular dystrophies,parkinsonism
and acute leukaemia.
Approved, prescribed drugs and medicines for the treatment of
Hypercholestrolaemia and Hypertension which are directly associated
with both forms of Diabetes are also available under the scheme.
I have an ongoing medical condition not listed. Is there any help
available to me?
Under the Drug Payment Scheme, a person and his/her dependants, who are
not
entitled to either a medical card or a long term illness
care, do not have to pay
more than a specified sum in any calendar month for approved prescribed
drugs,
medicines and appliances. Because the amount involved is subject to
budgetary changes you should contact the local H.S.E office for an up
to date figure.
If you are receiving ongoing medical treatment it would be worth your
while writing to the area Health Service Executive in the part of the
country you intend to settle in, outlining your condition and asking
them to write to you with information of what services are available in
the area.
Private Health Care /
Insurance:
Individuals are free to choose to take out
medical
insurance if they wish to avail of private treatment for themselves.
The companies operating in Ireland are VHI (Voluntary health Insurance)
VIVAS Health & BUPA.
Private Health Insurance in Ireland operates on a ‘community
rated’ basis which means that insurers must charge the same
premium for a particular level of cover regardless of age, gender or
health status. They cannot base their insurance policies on risk. Irish
health insurance legislation also provides for ‘open
enrolment’ which means that insurance companies must make
insurance cover available to people aged under 65 years of age
regardless of whether or not they were insured before. The law in
Ireland also provides for ‘life cover’ which means
that
once you are registered for health insurance cover you cannot be told
by the company that they are no longer willing to insure you, except in
very exceptional circumstances. The taking out of private health
insurance in Ireland is
essentially a
voluntary decision on the
part of the
individual.
Transferring
Pensions & Benefits
State pensions, job related pensions and private
pensions will transfer with you. It is very unlikely than any social
welfare payments will so check this with the agency paying you. When
you return to settle permanently in Ireland you will be liable for tax
here.
Tax matters:
Foreign Pensions: For those coming from the USA
Question: I am resident in Ireland
and in receipt of a pension from the USA. Is this taxable in Ireland or
in the USA?
Answer: All USA pensions received by
an Irish resident whether occupational or social welfare, are only
taxable in Ireland.
Explanation: If you are a US citizen
(have taken out US nationality) and are not an Irish citizen (gave this
up when becoming a US citizen) your pensions are taxable in the USA. If
you are an Irish citizen then the pension is only taxable in Ireland.
If you hold dual US / Irish nationality your pension is
taxable in Ireland but you should contact the US Tax Authority to
confirm this because there may be some exceptions to the rule. See 'Deductions
from overseas pensions at source' below
You must notify the local Tax office
(where you move to in Ireland) that you are now living here permanently
and they will assess you for income for tax. Please check the question
of dual nationality with them if this is your situation. If you are
paying tax on your pension (where you are living) at the moment you may
have to pay tax here.
The
situation for Irish Citizens moving home from other (non UK) countries:
European Countries: An EU pension or
other income received by an Irish resident will be taxable in Ireland
depending on whether or not Ireland has a Tax Treaty with the country
involved. In all cases you will need to clarify your situation with the
local Tax office where you move to in Ireland.
Zimbabwe: A Zimbabwean pension or
other Zimbabwean income received by an Irish resident will be taxable
in Ireland. Because Ireland does not have a Tax Treaty with Zimbabwe
the individual will be taxed, by Ireland, on the amount received after
the Zimbabwean tax has been deducted. No credit will be given against
the Irish tax liabilities for tax deducted in Zimbabwe. So, if you are
returning from Zimbabwe you may find yourself paying tax in both
countries.
South Africa: Ireland does have a tax
treaty with South Africa so the Irish Revenue will give credit for any
tax deducted in South Africa against any Irish tax liability.
Australia and Canada: Pensions paid
to an Irish resident are taxable in Ireland only and not in Australia
(with one exception - see deductions from pensions at source below) or
Canada. That means that Australian or Canadian tax should not be
deducted but the income should be declared in Ireland. Social Security
pensions to returning emigrants from Australia are distributed from
England on a monthly basis.
You must notify the tax authorities in Australia or
Canada (whichever country you are coming from) that you are moving,
permanently, to Ireland and will be assessed for tax by the Irish
Revenue.
Deductions
from pensions at source: Until you get your
situation sorted out with the Revenue here, Social security pensions
from the USA will suffer a 15% withholding tax from the IRS when you
move but this can be offset against any Irish tax you may be liable
for. Anecdotal information is that this is also the case with pensions
being transferred from Canada and Australia. If someone is entitled to
a pension from Veterans Affairs in Australia, it must be paid into an
Australian bank first and then transferred to you in Ireland.
For everyone
regardless of where they are coming from:
In all cases you must notify the local Irish Tax office
of your permanent residency here. Not to do so is breaking the law. You
should also notify the Tax Authority in the country you are leaving.
A word of
advice:
Tax matters are very personal so can be different
depending on someone's individual circumstances. The information in
this leaflet is intended as a general guide for older people returning
to Ireland, in receipt of pensions from abroad. We advise everyone to
contact the Tax Authorities in the country they are leaving and local
Tax office on arrival in Ireland to clarify his or her individual
situation.
Q. Is it
necessary to transfer my income from abroad?
A. Many returning emigrants ask do
they have to transfer their pensions to Irish banks when they come to
live in Ireland? If someone is moving to Ireland without a full pension
they may require the Irish Government to give them a 'top up' payment
to bring their income up to the basic Non-Contributory Pension payment
here. If you are eligible to apply for Rent Allowance, Living Alone
Allowance, the Household Benefit Package (Electricity or Natural Gas
Allowance, Telephone line / Equipment Rental and something towards Call
Charges and a Free Television Licence) and, if you apply for a Medical
Card you will be required to show your income.
So! It might be easier if you have transferred your
pension/s to an account here in Ireland where the money will be shown
in Euro (€) and be simpler for officials to calculate your
financial position and decide what, if anything, you are eligible for.
You can keep your bank account abroad and continue to have your
pension/s paid into it if you want to, but it may cause you difficulty
when dealing with Irish officials.
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