I happened to have my first professional experience with a Form MC1 Form today or in English a Medical Card Application Form. As a tax head the following caught my eye that is outlined on the Form. You’ll have to bear with me if I get a bit technical for a little while but I’ll explain it all jargon free in a bit.
Who may apply? “Anyone who is ordinarily resident in Ireland can apply. Ordinarily Resident means that you have been living here for at least one year or intend to live here for at least one year”
Now that might sound fair enough, except that is not what ordinarily resident means. Ordinary Residence is defined by S820 of the Tax consolidation Act as
“For the purposes of this Act an individual shall be ordinarily resident in the State for a year of assessment if the Individual has been resident in the State for each of the 3 years of assessment preceding that year”
For the purpose of this article it is important to note that it takes three years to lose ordinary residence also- you have to be non resident for three years- this will become important.
Big difference. Since 1991 Millions if not Billions in the difference.
As the tax acts definition covers tax legislation and is to be confined to such I did a bit of research.
Medical card eligibility is covered by the Health Act 1970 as amended by the Health Act 1991.
It is the 1991 Act that introduced the concept of ordinary residence as a condition for a medical card. It is not definded but rather the Minister may issue guidelines
Guidelines on "Ordinarily resident in the State".
4.—The Act of 1970 is hereby amended by the insertion of the following section after section 47:
"47A. The Minister may issue guidelines to—
( a ) the chief executive officers of health boards, and
( b ) persons appointed or designated by him under section 47 (1),
to assist each of them in deciding whether or not a person is ordinarily resident in the State for the purposes of sections 45 and 46".
http://www.irishstatutebook.ie/1991/...tml#zza15y1991
In the HSE’s own guide to the Medical card application procedure it outlines what those guidelines issued were:
http://www.hse.ie/eng/services/Find_...guidelines.pdf
Following consultation between the Department of Health and the Health Areas, the Minister for
Health is, under Section 47A of the Health Act, 1970 (as amended by the Health (Amendment) Act, 1991) issuing the following guidelines on the interpretation of the criterion of ordinary residence.
The guidelines deal with the interpretation of ordinary residence under the following headings:
• nationals of non-EC countries;
• nationals of EC countries other than Ireland;
• Irish nationals who have been resident outside Ireland
References in the guidelines to “satisfying the Health Area” imply satisfying the Chief Executive
Officer or any officer to whom the function of determining eligibility for health services had been
delegated by the Chief Executive Officer. In all cases the Health Area is entitled to seek such
evidence as it may require in order to reach its decision.
1 Nationals of non-EC countries
1.1. An non-EC national should be regarded as “ordinarily resident” in Ireland if s/he satisfies the
Health Area that it is his/her intention to remain in Ireland for a minimum period of one year.
Examples of the evidence which may be sought in this context include
• proof of property purchase or rental, including evidence that the property in question is the
applicant’s principal residence;
• evidence of transfer of funds, bank accounts, pensions;
• Alien’s Registration Book (“Green Book”), residence permit as stamped on passport;
• work permits or visas, statements from employers etc;
• where necessary, the signing of the affidavit by the applicant
1.2. A non –EC national who is in Ireland as a student should be regarded as “ordinarily resident”
if s/he is attending a registered course of study of at least one academic year’s duration.
1.3. A dependant of a non-EC national must also satisfy that criterion of “ordinary residence” in
order to establish eligibility for health services here i.e. the fact that a non-EC national has
established his/her eligibility does not imply that non-resident dependants are also eligible.
1.4. A non-EC national may have established an entitlement to cover under EC regulations as a
result of residence or employment in an EC country. In such cases, the arrangements set out in
Paragraphs 2.1 and 2.2. apply.
2 Nationals of EC countries other than Ireland
2.1. Arrangements under EC regulations supercede the provisions of the Irish eligibility system is
respect of certain categories of nationals of other EC countries:
• social security pensioners of other EC countries who are not covered by an Irish social
welfare pension (as recipient of dependant), and who are not employed or self-employed
here, receive a Medical Card;
• persons resident here who are insured workers in the territory of another EC country receive
a Medical Card;
3 Irish Nationals who have been resident outside Ireland
3.1 Where an Irish national who returns to Ireland following residence in another EC country is
covered by any of the arrangements made under EC regulations, the same approach as that set out in Paragraph 2.1 should be taken.
3.2 Where and Irish national returns to Ireland and is not covered by any of the arrangements
made under EC regulations, s/he should be regarded as “ordinarily resident” here if s/he
• is employed or self-employed here; or
• satisfies the Health Area that it is his/her intention to remain in Ireland for a minimum period
of one year.
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3.3 Where an Irish national is working abroad on a short-term contract but satisfies the Health
Area that it is not his/her intention to take up residence outside of Ireland on an indefinite basis, the status of “ordinarily resident” and eligibility for Irish health services may be retained. The Health Area may take account of the nature and duration of the contract as well as evidence such as the examples in Paragraph 1.1 in arriving at its decision.
Health Area is satisfied that the person did not establish an entitlement to health services in any other country, the Health Area should (if Paragraph 3.2 does not apply) regard the person as “ordinarily resident” in Ireland if s/he requires treatment on returning to Ireland. This guideline is intended to ensure, in particular, that persons who emigrate do not lose their health services eligibility on residence grounds before they have been able to establish eligibility elsewhere. It would not apply where a person is covered by EC Regulations and, in particular, it would not entitle a person temporarily resident in another EC country to have the Health Area extend the Form E111 beyond the normal period.
4 Persons deemed not to be “ordinarily resident”
4.1. Where a person is deemed not to be “ordinarily resident” in Ireland, and where none of the
other provisions set out above apply, the Health Area may either
- apply the full economic charge for any services provided;
Or - provide urgent necessary treatment at a reduced charge or without charge
(as deemed appropriate by the board) where application of the full economic charge
would cause undue hardship.
5 “Urgent necessary treatment”
5.1. The references to the provision of urgent necessary treatment free of charge to temporary
visitors from another EC country (Paragraph 2.1) and to persons deemed not to be “ordinarily
resident” here (Paragraph 4.1) do not cover
• non-urgent or elective treatment which can reasonably be postponed until the person’s return
to his/her own country;
• any case in which a person travels to Ireland for the specific purpose of obtaining treatment.
Department of Health
7 July 1992
What the hell was the Department of Health thinking. And how has this thinking (if you could call it that) been allowed to exist for almost 20 years. By incorporating the meaning of ordinary residence as it is outline by the tax acts this country could have saved billions in Medical expenditure on people that have turned up in Ireland, paid for a mickey mouse English course and allowed to have free medical treatment and then up sticks and went home. The department had to issue guidelines to cover Irish nationals that may have spent a year abroad and suddenly would not be entitled to medical treatment. Incorporating the tax legislation definition would guarantee them treatment for up to three years. There is provision in the Guidelines for urgent necessary treatment for those that need it free of charge. Why are we opening the door for those that do not require urgent medical treatment free of charge just because they are resident for part of the year? One year. Free medical card. This sort of thinking is the reason that A&E is overcrowded and we are propping up medical treatment for those that in my opinion should not be entitled to it and wasting millions in taxpayers money for those that have made little or no contributions to the Tax system to subsidise their treatment. It is nothing short of a scandal.
