Medical card and doctors fees

bannabeach

Hello My husband and I have just received our medical cards due to my husbands serious illness and loss of job too. We have never had a card before so it's a bit new to us. I told a friend recently that we got medical cards and she told me that our doctor only gets 70 euro for each of us per year so I was shocked to hear this as I'm now afraid to use up our visits in case our GP gets annoyed with us visiting him to often. my husband will have to be seen for a fair amount of times due to his illness could he be given my 70 euro worth do you think, although we have a nice GP surely he will not be happy with me making appointments that would exceed what he gets for us can anyone give us advise please thank you

The Diddakoi

According to Citizens information:

http://www.citizensinformationboard.ie/publications/relate/relate_2014_03.pdf

"Payments to doctors and pharmacists
The payments to doctors for caring for medical card patients
vary in accordance with the age, sex and circumstances of the
patient. The detailed payments are set out in SI 277/2013 and
SI 278/2013.
Doctors are paid on what is known as a capitation basis. This
means that they get an annual payment in respect of each
patient regardless of how many times the patient is seen.
There are a range of other payments including out-of-hours
payments and payments for home visits. There are some
services for which a specific fee is also paid, for example,
the administration of certain vaccines. Doctors may also
get payments for practice support staff and there is a rural
practice allowance.
The capitation payment ranges from €43.29 for a boy aged
between 5-16 to €434.15 for a person aged 70 or over living
in a private nursing home. Examples of other payments are:
• €271.62 in respect of a person aged 70 or over living in
the community
• €110.38 in respect of a man aged between 45 and 65
• €121.29 in respect of a woman aged between 45 and 65
Pharmacists are paid the cost of the prescribed drugs
and medicines (or the interchangeable equivalent) plus
a dispensing fee."

So it looks like they get a set fee a year for having you registered whether you attend or not, and then a payment for each treatment or visit you have.

Rates are set out in the Irish statute book, http://www.irishstatutebook.ie/2013/en/si/0278.html but it makes heavy reading

You are entitled to a medical card, please don't feel guilty for using it

Euphoria Intensifies

I think that person might have the wrong information bannabeach. I have a medical card due to long term illness/disability and have definitely had to visit my GP way more times in one year than the equivalent of 70 euro's worth of apps. Sure that would barely get you seen twice these days.

Your husband will be able to visit the GP as much as he needs to, as will you. If you are prescribed medications, you have to pay a charge of €2.50 per item (however, if your husband has an illness that is covered under the Long Term Illness scheme - diabetes, cystic fibrosis etc - I'm pretty sure these meds are totally free).

I hope that helps. As alf66 says, you and your husband are entitled to a card so don't feel guilty about using it when you need to.

bannabeach

Thankyou so much guys for your kind replys so are ye saying that my husband and I can go as often to the GP and that will e

bannabeach

And that will be ok and that the GP won't mind how often but surely if he only gets a little fee for us both of us he would still not be happy with us coming to see him too often sorry if I'm coming across as an idiot but so so much has happened with us recently we all over the place

Euphoria Intensifies

My GP or the surgery they're based in has never had an issue with the number of appointments I've had anyway (and sometimes I've had very regular apps, weekly even), so I'd say you and your husband will be fine. If you're still concerned, ring your GP and ask him to make sure.

bannabeach

Thanks again for your prompt reply I really appreciate it our GP is a nice person so hopefully he will not discourage us from making extra appointments

GerardKeating

Euphoria Intensifies wrote: »

My GP or the surgery they're based in has never had an issue with the number of appointments I've had anyway (and sometimes I've had very regular apps, weekly even), so I'd say you and your husband will be fine. If you're still concerned, ring your GP and ask him to make sure.

Our GP has a sign up, that suggest more than one a month might be considered "over visiting" and patients might consider if they really needed to visit so much, but most GP's would realise that that some conditions do warrant more regular visits that the "norm"

medicine12345

alf66 wrote: »

According to Citizens information:

http://www.citizensinformationboard.ie/publications/relate/relate_2014_03.pdf

"Payments to doctors and pharmacists
The payments to doctors for caring for medical card patients
vary in accordance with the age, sex and circumstances of the
patient. The detailed payments are set out in SI 277/2013 and
SI 278/2013.
Doctors are paid on what is known as a capitation basis. This
means that they get an annual payment in respect of each
patient regardless of how many times the patient is seen.
There are a range of other payments including out-of-hours
payments and payments for home visits. There are some
services for which a specific fee is also paid, for example,
the administration of certain vaccines. Doctors may also
get payments for practice support staff and there is a rural
practice allowance.
The capitation payment ranges from €43.29 for a boy aged
between 5-16 to €434.15 for a person aged 70 or over living
in a private nursing home. Examples of other payments are:
• €271.62 in respect of a person aged 70 or over living in
the community
• €110.38 in respect of a man aged between 45 and 65
• €121.29 in respect of a woman aged between 45 and 65
Pharmacists are paid the cost of the prescribed drugs
and medicines (or the interchangeable equivalent) plus
a dispensing fee."

So it looks like they get a set fee a year for having you registered whether you attend or not, and then a payment for each treatment or visit you have.

Rates are set out in the Irish statute book, http://www.irishstatutebook.ie/2013/en/si/0278.html but it makes heavy reading

You are entitled to a medical card, please don't feel guilty for using it

no they don't get an additional fee per each visit which is partly the reason why general practice is becoming non viable as more and more people are getting medical cards and the capitation fees paid to GPs have been cut alot.
So for example if a 6 year old boy attends 10 times a year, teh GP will get 4.30 euro per each visit....

In saying that if people are genuinely sick as the OP's husband is the GP will obviously not mind how often they attend if they are genuinely ill and should not feel guilty about attending

medicine12345

bannabeach wrote: »

And that will be ok and that the GP won't mind how often but surely if he only gets a little fee for us both of us he would still not be happy with us coming to see him too often sorry if I'm coming across as an idiot but so so much has happened with us recently we all over the place

I can see what you're saying here but don't feel guilty if you/your husband are genuinely unwell. Its only if people are coming on a regular basis for no reason that teh GP would be annoyed

The_Conductor

A lot of GPs are insisting on appointments only- as its impossible to see their patients otherwise. The last day I had to visit a GPs surgery- there were 36 people in the waiting room to see the GP- and I was the only non-medical card patient. I took an afternoon off work to see the GP- and eventually left,without seeing the GP- as I had to collect my kids from creche. I phoned the GPs surgery the following morning- and they agreed to fax an urgent prescription for me to my local pharmacy.

Frankly- I can see why GPs feel they are getting the thin edge of the wedge here- the system does not work- and handing out more GP cards is only going to make it worse for everyone.

I personally think that a small fee should apply for all GP visits for medical card holders- so people kept away with minor flus and colds etc.

Gael23

Once the reason for your husbands visit is genuine, his GP won't mind at all.

Pumpkinseeds

The_Conductor wrote: »

A lot of GPs are insisting on appointments only- as its impossible to see their patients otherwise. The last day I had to visit a GPs surgery- there were 36 people in the waiting room to see the GP- and I was the only non-medical card patient. I took an afternoon off work to see the GP- and eventually left,without seeing the GP- as I had to collect my kids from creche. I phoned the GPs surgery the following morning- and they agreed to fax an urgent prescription for me to my local pharmacy.

Frankly- I can see why GPs feel they are getting the thin edge of the wedge here- the system does not work- and handing out more GP cards is only going to make it worse for everyone.

I personally think that a small fee should apply for all GP visits for medical card holders- so people kept away with minor flus and colds etc.

Yes and No. I'm a medical card holder due to a long term illness and I would see my GP at least once a month. I don't think that any additional charge would stop time wasters from turning up for minor ailments that don't require a GP. If anything the waits will get longer due to free GP visits for under 6's. There'll be a surge of people bring little Johnny or Janey in whenever they have a sniffle. That's the biggest challenge facing GP practices in the future.

Gatling

The_Conductor wrote: »

The last day I had to visit a GPs surgery- there were 36 people in the waiting room to see the GP- and I was the only non-medical card patient. I took an afternoon off work to see the GP- and eventually left,without seeing the GP- as I had to collect my kids from creche. I phoned the GPs surgery the following morning- and they agreed to fax an urgent prescription for me to my local pharmacy

How did you know the 36 others were medical card patients .

Adding a small fee won't deter people going more frequently especially with kids .
Maybe it would make more sense having something similar to a triage system where a nurse can see families or kids with tempatures and advise if they need to see a gp or go home plenty of fluids and rest .
Especially most issues seem to be viral which they can't do a lot for .

Less medical cards for a start no way should half the population be covered by cards while less than a million are in full time employment it's not sustainable

Gael23

We have strayed a little off topic here but I think there should be a small fee for the under 6s scheme. Its a certainty that it will be abused and a fee of say €10 will help deter some of that.

The_Conductor

Gatling wrote: »

How did you know the 36 others were medical card patients .

I was told so by the secretary the following morning- she was quite apologetic that I couldn't stay- and very helpfully faxed the prescription through to the pharmacy for me (the surgery was in Blanchardstown- and I work in Celbridge- so it was going to be a hike to get back there- and I had taken a half day from work the preceding day to make the surgery- phoning and talking to the secretary in advance- so I knew what the opening hours were.

The secretary told me that almost all of their patients (of which there are between 30 and 70 a day) are medical card patients- they get 1 or 2 private patients a day. Some retired people seem to be using it as a social function- they meetup there every Tuesday like clock-work (which is the day they hit 70 patients), seems a bit bizarre to me to be honest- I don't see how it could be true.

Gatling wrote: »

Adding a small fee won't deter people going more frequently especially with kids .
Maybe it would make more sense having something similar to a triage system where a nurse can see families or kids with tempatures and advise if they need to see a gp or go home plenty of fluids and rest .
Especially most issues seem to be viral which they can't do a lot for .

Change it so its a reasonable fee to deter people from attending unless they have to- but not too much that they stay away if they are worried enough? A tenner a visit would be roughly the same as the cost of a pack of cigarettes? Don't just have it for kids- have it for all non-private patients. Private patients- pay the going rate (which seems to be between 50 and 80 Euro a visit- depending on the doctor)- everyone else pays a tenner. Free prescription pickup from a secretary for medical card patients- and charge private patients a tenner to pickup a prescription?

Essentially- it has to be a sufficient charge to discourage flippant use of the GP- however, not too high to stop people who need to go- from going.

Just put a tenner fee on anyone with a medical card of any nature. Make it a sufficient fee that you will find the money somehow if you need to go- but you won't go unless you need to. Yes- I know a tenner can be a lot of money- I've been in the position before where I've had to make a tenner last several days- and the tenner itself I found on the side of the road.........

Gatling wrote: »

Less medical cards for a start no way should half the population be covered by cards while less than a million are in full time employment it's not sustainable

The stated aim is to rollout free primary level care to the entire population- of which the under 6s is a first step. Aka- far from removing medical cards from anyone- they intend to give absolutely everyone one (when they can afford it- whenever that is). A significant number of those being hospitalised- are public patients who don't have medical cards- aka people who don't have free GP care- didn't visit their GP- and when they were ill enough- ended up being admitted to hospital- probably through A&E.

The whole system is completely and utterly nuts- presided over by an organisation who are creaking at the seams- yet appear answerable to no-one, not least of all, the Minister for Health.

Portugal's system- run on a far lower per capita rate than Ireland's- or the UKs- manages to offer universal primary level care- at a level which is rated as the 7th best in the world (according to the OECD). Our current system- is obviously failing massively- and indeed in the case of our interns- has been ruled to be illegal. How someone at the end of 100 hours on call is supposed to have the wherewithall to offer critical support to people.......

Anyhow- back to Medical Cards and Doctor's Fees- I think including GPs on the 144 DPS a scheme- whereby the most someone without a medical card would pay per month for GP and prescription charges would be 144- is fair and reasonable? For anyone under the 144 a month- charge whatever you want- up to the DPS limit. And for medical card patients- and under 6s- apply the same limit- x amount per items prescribed (well under the actual cost- unlike the DPS patients who pay the full price upfront up to the 144 threshold) and a tenner per GP visit- to a max of 144.......?