Healthcare in Ireland: the HSE, the cards and the S1 route
Without a card you pay the GP per visit in Ireland and your medicines yourself, up to €80 a month per family. The cards, medical card and GP visit card, have means tests, but the S1 route via the CAK gives pensioners a medical card *without* a test. Whoever leaves on early retirement does need to watch 1 November 2026 (expected, not yet final).
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Yes, if you live in Ireland you are entitled to public healthcare, but it isn't free by itself. Whoever is ordinarily resident, living there for at least a year or intending to, gets public healthcare free or at a reduced cost.
Without a card you pay the GP yourself and your medicines too. But under the Drugs Payment Scheme, the Irish scheme with a monthly cap on medicines, a family never pays more than €80 a month.
The finding is the S1 route. Whoever lives in Ireland on a Dutch social security pension such as the AOW and doesn't work there gets a medical card without a means test with the CAK's S1. The S1 is the European form that confirms your right to healthcare in your country of residence. The medical card is the Irish health card for free GP and hospital care.
The trap is for those who leave earlier. As things stand, the CAK expects early retirement pensions to no longer give access to that route from 1 November 2026.
What does ordinarily resident mean?
That you have lived in Ireland for at least a year or intend to. That is the gateway to public healthcare, and the HSE, the Irish health service, may ask you to prove it. You do that with documents no more than twelve months old, such as:
- a tenancy agreement or proof of purchase of your home;
- a bank statement;
- a utility bill;
- an insurance policy in your name;
- a letter from a government department, such as Revenue.
After that there is a big difference between those with a medical card and those without.
| Situation | GP | Medicines | Hospital |
|---|---|---|---|
| Medical card | free | free, with a charge per prescribed item | free |
| GP visit card | free | pay yourself, or via the Drugs Payment Scheme | public, free or with a charge |
| No card | pay yourself | up to €80 a month per family via the Drugs Payment Scheme | public, free or with a charge |
What is the Drugs Payment Scheme?
The safety net for those without a medical card. You and your family pay at most €80 a month for approved prescribed medicines and certain appliances. The only condition is that you are ordinarily resident, and you can apply online. Preferably use one pharmacy in a month. Whoever uses two can end up above €80 and then has to claim the excess back.
Who gets a card?
The medical card is the full card, with a means test. If you are 70 or older, you get it if your gross weekly income is below €550 as a single person, or €1,050 as a couple. Over 70 you get a GP visit card in any case, without a means test. Children under 8 also get one without a test. In between, the GP visit card has a test on your net weekly income, for example €418 for a single person living alone and €607 for a couple, with allowances for children.
How does the S1 route work?
For whoever comes with a Dutch pension, this is the rule that counts. If you have a social security pension from another EU country, such as the AOW, and you live in Ireland without working there or paying PRSI (the Irish social insurance contribution), you can get a medical card under EU rules. You submit the medical card form together with your S form. If the Netherlands confirms your entitlement to healthcare in Ireland, you don't have to do the financial assessment. Dependants who rely on you may also qualify.
You apply for the S1 at the CAK. The CAK advises starting three months before your move and handles the application within four weeks. You then pay a treaty contribution, which your pension fund or benefit agency usually deducts automatically.
If you leave before your AOW age, watch 1 November 2026. As things stand, the CAK expects that from that date new registrants in the EU and EEA will only be insured via the CAK with a statutory benefit: AOW, Anw, WAO, WIA or Wajong. Whoever only has an early retirement pension or a bridging payment, such as an RVU payment, must then arrange their own insurance until AOW age. Existing clients keep their rights. Ireland is in the EU; so this applies here too.
And if you work in Ireland?
Then you fall under the ordinary Irish system and not under the S1 route. Whoever works in Ireland and pays PRSI doesn't qualify for a medical card under EU rules, but possibly for a means-tested one. Until a card or the Drugs Payment Scheme takes over, you pay the GP and your medicines yourself, and hospital care is public with a charge.
The order once more
Before leaving you register with the CAK with your pension or benefit and apply for the S1. If you are going to work and have no Dutch pension or benefit, the CAK doesn't come into it. In Ireland you submit the S1 with the medical card form to the HSE, and apply for the Drugs Payment Scheme as soon as you are ordinarily resident. Where to get proof of address in your first weeks is covered in your first weeks in Ireland.
In Vertrekklaar this is phase 2 of 5 of the journey, step 2.1: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Ireland or go straight to step 2.1 in the open plan.
What this rests on
The facts in this article come from these official pages. Rules change. When in doubt, go by the source, not this article.
- Citizens Information — entitlement to public healthcare and the medical card under EU rules — citizensinformation.ie
- Citizens Information — the Drugs Payment Scheme — citizensinformation.ie
- Citizens Information — the GP visit card — citizensinformation.ie
- Nederland Wereldwijd — health insurance via the CAK when emigrating — nederlandwereldwijd.nl
- Citizens Information — the medical card over 70, the income limits — citizensinformation.ie
- CAK — moving abroad with a pension or benefit — hetcak.nl
- CAK — emigrating on early retirement, the expected change from 1 November 2026 — hetcak.nl
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