The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the Scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
While there are no current plans to extend the list of illnesses covered, my Department is currently examining all of the issues around the scope of the Scheme. It is also important to remember that the LTI Scheme exists within a wider eligibility framework.
This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility.
In 2022, a range of measures were delivered including the abolition of public inpatient charges for children, reductions in the Drug Payment Scheme threshold to €80 per month, and the introduction of free contraception for women aged 17-25.
The significant investment in Budget 2023 will facilitate better access to affordable, high-quality healthcare for people at a time when the cost-of-living crisis is impacting on everyone.
In 2023 this will mean:
• an expansion of GP care without charges to people earning no more than the median household income,
• all public in-patient hospital charges abolished since 17 April 2023,
• an extension of free contraception to 26-year-old women since 1 Jan 2023, and further extension to 27-30 years old women from 1 September 2023.
These measures continue to create a health and social care service that offers affordable access to quality healthcare.
In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines.
The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
