Expat insurance and health insurance in Ireland

Ireland has a tax-funded public healthcare system overseen by the Department of Health, with day-to-day operations run by the Health Service Executive (HSE) — a functional, though not legal, equivalent of French social security. Unlike the Netherlands, there is no legal requirement to take out private health insurance: access to public care depends on ordinarily resident status, recognised for anyone who has lived in Ireland for at least a year or intends to reside there for that long. This status opens two levels of cover: Category 1 (Medical Card, means-tested) gives free access to nearly all care — GP, public hospital, a wide range of medicines; Category 2, covering most residents without a Medical Card, leaves GP consultations chargeable (public hospitals remain free for any resident since the daily charge was abolished in April 2023).

The GP remains the system’s entry point: a referral letter waives the emergency charge (€100) and is a condition for free access to hospital specialists for public patients. Dental and optical care remain largely outside the free basket for Category 2 adults, as do medicines beyond the capped scheme (Drug Payment Scheme, €80/month/family for those without a Medical Card). With no legal requirement, about 46% of the population supplements this public cover with private insurance (VHI, Laya Healthcare, Irish Life Health), which gives direct access to the private sector and reduces waiting times in the public system, reputed to be long for non-urgent care.

• EU citizen: no visa required, free stay; beyond 3 months, the stay remains authorised subject to sufficient resources (work, studies, own means). Ireland does not issue a residence permit to EU citizens and imposes no registration procedure with immigration services.
• PPS Number (Personal Public Service Number): to be requested as soon as you settle, from the Department of Social Protection — a practical requirement for working, opening a bank account or applying for a Medical Card.
• Ordinarily resident status: recognised by the HSE after a year of actual presence or intention to reside long-term in Ireland; opens eligibility to Category 1 (Medical Card, means-tested) or Category 2.
• Medical Card: weekly net income thresholds (after tax, PRSI, USC) — around €184/week for a single person living alone, €164/week if living with family, higher thresholds for a couple or dependants (under 70). Above that, the HSE automatically assesses eligibility for a GP Visit Card (thresholds around 50% higher, covering GP visits only). Automatic assignment with no means test for people over 70 (subject to their own income conditions) and for children under 8.
• Student: the EHIC is enough for a temporary stay (Erasmus-type); for a long-term enrolment, ordinarily resident status applies after a year and a supplementary student insurance remains recommended during the transition period.
• Seconded employee : up to 24 months (extendable), stays on the French scheme via form A1, exempt from local procedures.
• Retiree: form S1 from their French pension fund before departure, for cover by the HSE with no new contribution of their own.

No fine applies for lacking supplementary cover, unlike in the Netherlands: the risk is purely financial, particularly for non-free care (Category 2 GP visits, emergencies without a referral, hospitalisation as a private patient), with no help from the French embassy.

As Ireland is an EU member state, there is no classic bilateral agreement with France: coordination runs through EU regulations 883/2004 and 987/2009, as for other member states.

• Temporary stay: the EHIC covers the same care as an Irish insured person with doctors and dentists participating in the Primary Care Reimbursement Scheme (PCRS), public hospital emergencies, and prescribed medicines (capped at €1.50/item, €15/month) — an upfront payment may still be required depending on the practitioner consulted.
• Secondment: form A1, staying on the French scheme for up to 24 months (extendable), exempt from local procedures.
• Long-term move: ordinarily resident status after a year, access to Category 1 or 2 depending on income; form S1 for a retiree, covered by the HSE with no new contribution of their own.
• The EHIC covers neither repatriation, nor planned care, nor a long-term move beyond a temporary stay.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Seconded employee: request form A1 from your French fund before departure.
3. Retiree: request form S1 from your pension fund before departure.
4. Before departure or on arrival: request the EHIC to cover the transition period.
5. On arrival: request a PPS Number (Personal Public Service Number) from the Department of Social Protection.
6. Register with a GP participating in the medical scheme, the entry point into the care system.
7. After a year of actual residence (or as soon as long-term residence is intended): request recognition of ordinarily resident status and, depending on income, a Medical Card or a GP Visit Card from the HSE.
8. Register with the roll of French nationals living abroad (French Embassy in Dublin).