Border People provides case studies and frequently asked questions (FAQs) illustrating the dilemmas facing people who cross the border and suggest ways to resolve these.
These are real genuine problems identified by users of the website coupled with advice from staff of the Borderwise project, a cross-border initiative developed in partnership between Citizens Advice (Northern Ireland) and Citizens Information Board (Ireland).
Q: Following surgery and early retirement I moved from Derry to Donegal but I have continued to attend Derry Hospital for check ups. Is this OK given my southern residency?
A: Once you are no longer a UK resident and no longer employed there, you are no longer entitled to access the NHS in the north on a routine basis, regardless of the fact that you have paid national insurance. You may, subject to a means test, qualify for an Irish medical card which would entitle you to free public healthcare in Donegal. There are quite low income guidelines for an Irish medical card but you should contact your local Community Welfare Officer in Donegal to see if you are eligible as there is some discretion depending on the nature of the applicant's health problems.
Q: As a resident of NI when I take up residence in a specific town I can register with the GP practice of the local area. Is this the same in Ireland ie if I live in a town/townland of Co Monaghan can I register with the local GP? Also if I am working in NI and live in townland of Co Monaghan are there National Insurance stamps/payments ie healthcare card to pay for my healthcare in Ireland
A: You can of course register with a GP in Monaghan if you move there. Generally healthcare is not free in the Republic of Ireland. However if you are living in Monaghan and working in NI you will be entitled to an Irish Medical Card from the Health Service Executive in the Republic without the usual means test. This card would entitle you to free public healthcare in the Republic. You can also continue to access the NHS in NI for as long as you remain employed there even if you move to Monaghan.
Q: I work in Belfast and my wife works in Omagh and we recently moved to live in Aughnacloy. The reason I am contacting you is to ask if we were to live across the border in the south could we still go to a GP practice in the Aughnacloy (in the north)?
A: Whilst you are still working in N. Ireland you are still entitled to access the NHS in the same way including GP services even if you are resident in the south. Healthcare in the south is generally not free. However if you and your wife are resident in the south and employed in the north you will both be entitled to an Irish Medical Card from the Health Service Executive in the south. That card entitles you to free public healthcare in the south and more importantly would cover any dependent children.
Q: I am a Frontier worker; I live in Ireland and work in Northern Ireland. I have been told that I can obtain a medical card in Ireland without having to undergo the means test. Is this correct?
A: Under European Union Regulations, Medical Cards are granted to the following categories of people regardless of their means:
- Pensioners living in Ireland who are receiving a Social Security Pension from another EU State, regardless of income, provided they are not employed or self-employed here, and are not receiving an Irish Social Welfare Pension
- People who have a Social Security Pension from another EU State and an occupational pension from Ireland (including Civil Service or Public Service pensions) are eligible for a Medical Card under this rule. (Note that people in this situation may be given form E121 if they retire to another EU country, i.e. a Civil/Public Service pension will be treated as a Social Security pension for the purpose of getting the equivalent of a Medical Card in that country).
- Family members of someone working and paying social insurance contributions in another EU State, and who are living in Ireland, are entitled to a Medical Card provided they are not employed or self-employed in Ireland and are not receiving a Social Welfare payment in Ireland.
- Frontier Workers - If you live in one Member State and work in another, you are entitled to health services both where you live and where you work
- Posted Workers - persons who are assigned to Ireland by an employer in another EU state.
- Unemployed persons seeking work in Ireland and covered by Form 119.
- Students from other EU countries
Whilst there is no means test as such for people entitled to a Medical Card under EU Regulations, Health Boards are entitled to ask for any relevant information necessary to establish that an application falls within the provisions of EU Regulations. A Medical Card normally covers the applicant's spouse and dependants.
However, if a spouse is receiving a Social Welfare Pension (no matter how small), or is employed or self-employed in Ireland, then s/he would fall under Legislation in Ireland and would be means-tested in the normal way.
Q: I live in Northern Ireland and I have had diabetes for over 9 years, if I move to Monaghan will I be entitled to regular free medical check-ups (optician, dentist)?
A: Generally healthcare is not free in the Republic of Ireland so that most residents have to pay for GP visits, medication, hospital treatment and dental care or are covered for these costs under private health insurance. People who are entitled to an 'Irish Medical Card' are entitled to free public healthcare although this is usually means-tested. See www.citizensinformation.ie, Medical Cards or www.hse.ie for the income guidelines for an Irish Medical Card. A 'GP Visit' card which has a higher income guideline allows you to visit the GP for free only. As someone suffering from diabetes you should also be entitled to a 'Long Term Illness Card' from the Health Service Executive in the Republic if you move there. This is not means-tested but only allows you to obtain medication or appliances which are necessary for the treatment of your diabetes for free.
Q: I reside in ROI and am working in NI. Am I and my family entitled to free medical/dental care in NI.
A: As you work in NI you are entitled to routine NHS treatment, which includes free GP treatment and a standard prescription charge of £6.85. Dental treatment is generally not free. That right does not extend to your family. However as a cross-border or frontier worker resident in the Republic you are also entitled to an Irish medical card from the Health Service Executive in ROI. This entitles you free public heatlhcare in ROI and may cover dependent members of your family depending on whether or not your wife is employed in ROI or otherwise subject to ROI social security legislation.
Q: I live in Northern Ireland but am employed as a PAYE worker in Ireland. I have been told that I am exempt from the Health Contribution of PRSI (Pay-Related Social Insurance). Is this correct?
A: No, you are not exempt from the Health Contribution unless your income is at a sufficiently low level that you would be able to qualify for a Medical Card in Ireland and be exempt from the Health Contribution as the holder of the Medical Card.
© Northern Ireland Association of Citizens Advice Bureaux (NIACAB) 2008
