CA CCFRM604 2013-2024 free printable template
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How to apply for a medical card and GP visit card medical cards allow people to access a family doctor prescribed medicines community health services dental services hospital care and a range of other benefits at a reduced rate or free of charge GP visit cards allow people to access a family doctor only free of charge to qualify for a medical card or GP visit card you must be assessed initially on your financial situation as set out in the national assessment guidelines we also ask you to supply information of any ongoing medical issues if you don't qualify through the means test this will allow us to consider your application on a discretionary basis for undue hardship related to your medical or social issues some people may also qualify under automatic entitlement for more information on automatic entitlement and other questions visit medical card IE this video will take you through the application form step by step and show you examples of the documents you need to supply that will help us process your application as quickly as possible in part 1 of the form we need your personal details remember to fill in your PPS number you'll find it on your payslip or p60 form if you're married you're in a partnership you'll need to fill in the details for your spouse or partner even if they're not living in Ireland in part two we need personal details for all your dependents next you need to show us your family income, so we can determine if you qualify for a medical card or GP visit card if you get a social welfare payment send us post office receipts or a bank statement showing instances of these payments if your payment goes directly into your bank account the bank statement must show your name and address we cannot accept printouts from online banking if you're getting illness or maternity benefit for less than 12 months send us a letter from your employer stating if you're being paid or not if you are being paid or are on a reduced payment send us your most recent payslips if you're working send us copies of your most recent payslips if you're retired and your income is from a private or occupational pension send us your most recent pension payslips if your job has ended within the last two years please send in a copy of your most recent p45 in addition to your current income details if you're self-employed send us a copy of your most recent notice of assessment from the Revenue Commissioners all the pages must be supplied if you're applying under EU regulations send us a current BS one form which is issued by the relevant States Health Authority if you get a payment from any other state send us a letter from the pension provider or copies of your most recent payslips if you get a maintenance payment send in the court order maintenance agreement or a letter from the person paying maintenance to you confirming the amount and the frequency of payments remember you need to include the relevant documents for your spouse or partner's income even if they...
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