Written answers

Thursday, 19 December 2013

Department of Health

Medical Card Eligibility

Photo of Kevin HumphreysKevin Humphreys (Dublin South East, Labour)
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347. To ask the Minister for Health if the Health Service Executive intend to pursue the recouping of costs associated with the issuance of non-means tested medical cards to EU citizens under EU Regulation 883/04 in 2013 or 2014; and if he will make a statement on the matter. [54822/13]

Photo of Kevin HumphreysKevin Humphreys (Dublin South East, Labour)
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348. To ask the Minister for Health if the Health Service Executive or the PCRS have an estimate on the cost of issuance of non-means tested medical cards to EU citizens under EU Regulation 883/04 for countries with which from which we do not get reimbursed; and if he will make a statement on the matter. [54823/13]

Photo of Kevin HumphreysKevin Humphreys (Dublin South East, Labour)
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350. To ask the Minister for Health if he is satisfied with the current situation with respect to the reimbursement of health care costs under EU regulation 883/04, the collation of information by the PCRS with regard to who has been given these entitlements and the failure to have reimbursement agreements with 26 out of 27 EU countries; and if he will make a statement on the matter. [54825/13]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I propose to take Questions Nos. 347, 348 and 350 together.

Regulation (EC) 883/2004 and Implementing Regulation 987/2009 provide for the coordination of social security systems, including healthcare, within the EU/EAA and Switzerland. Under its provisions, persons residing in Ireland who are attached to the social security system of another member state are entitled to receive health care services in Ireland at the cost of that member state, provided they are not subject to Irish social security legislation. Persons in this category are entitled to full eligibility and receive a medical card as evidence of their entitlement. An estimate on the cost of the issuance of such medical cards under EU Regulation 883/04 is not available.

The EU Regulations provide for the costs to be reimbursed between member states. The Regulations also allow for two or more states to agree alternative arrangements for reimbursement other than those laid down in the Regulations, or to mutually waive reimbursement altogether. Ireland has had waiver agreements with a number of member states whereby costs arising under the application of the Regulations were mutually waived. Many of these agreements have been terminated in recent years. In view of this and of the increased numbers availing of services since the EU was expanded, the Health Service Executive intends pursuing the recoupment of costs from other member states. The Executive is currently in the process of preparing claims for recoupment of costs associated with medical cards issued under EU Regulations with a view to issuing these claims in 2014. The Health Service Executive is also currently working on systems to capture costs associated with the provision of healthcare under the European Health Insurance Card (EHIC) so as to enable it to commence the issuing of claims for reimbursement of costs to the relevant competent member states in the near future.

It must be noted that Ireland's primary interaction has been and continues to be with the United Kingdom with whom it operates a bilateral healthcare reimbursement agreement, covering such persons as temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and the dependant families of persons employed in the other country. Under the terms of the agreement net liability between the two countries is calculated on a lump sum basis rather than an individual basis. The payment made in any one year is based on an estimate of the number of persons falling within categories eligible for reimbursement and for whom each country is liable and an estimate of the the average cost of providing healthcare treatment. The amount received by Ireland from the United Kingdom in respect of reimbursement of healthcare costs provided under the relevant EU Regulations was €220 million in 2012. A similar amount has been received this year.

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