There is a scheme in Irish healthcare that gives you certain medicines free for life, ignores your income entirely, has no age limit, and does not even charge the usual prescription fee. There is also a fair chance nobody has ever mentioned it to you. It is called the Long-Term Illness Scheme, and if you or someone close to you lives with Type 2 diabetes, epilepsy, Parkinson’s or multiple sclerosis, it deserves ten minutes of your attention.
It is also one of the more peculiar survivals in Irish health policy. The list of conditions it covers was drawn up in the early 1970s, last amended in 1975, and has not moved since.
TL;DR
- Free medicines and appliances for 16 named conditions, with no means test, no age limit and no prescription charge.
- The list comes from Section 59(3) of the Health Act 1970, with regulations made in 1971, 1973 and 1975. Nothing has been added since.
- Diabetes accounted for 78% of scheme spending in 2021 and epilepsy for 8%. Claimants grew from 71,000 in 2013 to 195,000 in 2021.
- It covers only what treats the listed condition, not GP visits, hospital charges or your other medicines.
- If your condition is not listed, the Drugs Payment Scheme caps household medicine costs at €80 a month. Apply for the LTI through your primary care centre with a medical report from your GP.
What the scheme actually is
The Long-Term Illness Scheme, usually shortened to LTI, is run by the HSE’s Primary Care Reimbursement Service. If you have one of 16 listed conditions and are ordinarily resident in Ireland, meaning you live here and intend to stay at least a year, the approved drugs, medicines and appliances used to treat that condition are free.
The word “free” is doing more work here than elsewhere in the Irish system. A medical card holder still pays €1.50 per item, capped at €15 a month per person or family, dropping to €1 per item and €10 a month once you turn 70. Someone on the Drugs Payment Scheme pays up to €80 a month. An LTI cardholder pays nothing for the medicines treating their listed condition, prescription charge included.
There is no means test. Your income, savings and property are irrelevant. The absence of both a means test and a co-payment makes the LTI genuinely unlike every other community drugs scheme in the country.
The sixteen conditions
- Acute leukaemia
- Cerebral palsy
- Cystic fibrosis
- Diabetes insipidus
- Diabetes mellitus (gestational diabetes is not included)
- Epilepsy
- Haemophilia
- Hydrocephalus
- Intellectual disability
- Mental illness, for people under the age of 16 only
- Multiple sclerosis
- Muscular dystrophy
- Parkinsonism
- Phenylketonuria (PKU)
- Spina bifida
- Conditions arising from the use of Thalidomide
One note on language: the original 1971 wording used “mental handicap”, a term rightly retired. The HSE now lists it as intellectual disability. The vocabulary has been modernised even where the policy has not.
Why this matters particularly after 50
Read that list again with an older reader in mind and it changes character. Diabetes mellitus includes Type 2, the diagnosis most likely to arrive in your fifties or sixties. Parkinsonism, multiple sclerosis, epilepsy and acute leukaemia all show up in later life, and late-onset presentations are often put down to ageing first.
The numbers bear this out. A 2022 spending review by the Irish Government Economic and Evaluation Service found scheme costs had risen 175% in eight years, from €106 million in 2013 to €292 million in 2021, with claimant numbers rising from 71,000 to 195,000. Diabetes alone accounted for 78% of that spending and epilepsy for a further 8%, and nearly nine in ten new claimants came from those two conditions.
If you have been living with Type 2 diabetes, epilepsy or multiple sclerosis for years and paying through the Drugs Payment Scheme, that may be €80 a month you never needed to spend.
What it does not cover
This is where people get caught out. The card covers approved products for your listed illness and nothing else. Blood pressure tablets, painkillers, inhalers and anything unrelated are paid for in the ordinary way. It is also purely a medicines and appliances scheme, so it does not pay for GP visits, hospital charges or consultant appointments. Someone with an LTI card for diabetes and no medical card still pays full price to see their GP. The two are separate, and you can hold both.
The list that stopped in 1975
Now consider what is absent. Arthritis. Asthma. COPD. Heart failure. Dementia. Osteoporosis. Every cancer other than acute leukaemia. Thyroid disease, as we noted when writing about interpreting thyroid results after 50. These are, broadly, the chronic conditions of later life, and they reached the national health agenda long after the list was sealed.
The 2022 review put it plainly, noting that granting eligibility on the basis of specific named conditions “presents challenges regarding equity and fairness”. It also found such condition-list schemes are uncommon internationally, with only six other EU countries operating anything similar. The Department of Health has committed to examining eligibility under the wider Sláintecare reforms, but successive health ministers have told the Dáil there are no plans to extend the list. The practical takeaway is blunt: do not wait for your condition to be added.
If your condition is not on the list
- Drugs Payment Scheme. Caps your household spend on approved prescription medicines at €80 a month, covering you, your spouse or partner, and dependent children. Registering also gives access to free HRT, which has been available to DPS registrants since 1 June 2025.
- Medical card or GP visit card. Both are means tested, and people aged over 70 are assessed under separate, more generous limits. If you were refused years ago on income that has since fallen, apply again.
- Use one pharmacy. Splitting prescriptions across two pharmacies in a month can push you past the €80 DPS threshold. You can claim the excess back, but one pharmacy avoids the paperwork.
How to apply
Get a form from your local primary care centre, download it from the HSE, or ring 0818 22 44 78 and ask for one by post. Your GP or consultant must sign it and supply a medical report confirming the diagnosis, so raise it at your next appointment rather than making a separate trip.
You also need to show you live in Ireland. A utility bill dated within the last three months, a recent bank or credit union statement, a current car or home insurance policy in your name, or an official document from Revenue or a local authority will all do. Post the form to the Long Term Illness Scheme, Client Registration Unit, PO Box 12962, Dublin 11, D11 XKF3. Queries go to [email protected].
One current wrinkle: the HSE has temporarily paused printing plastic health cards, including LTI cards. You will get a letter confirming eligibility instead, and it is valid proof at the pharmacy counter. Do not assume the application failed because no card arrives.
Worth the conversation
The most useful thing you can do with this article is mention it to somebody. The scheme is not advertised, it is not automatic, and nobody in the system is assigned to notice that you qualify. Your pharmacist is often the best person to ask, because they can see what you pay each month and whether any of it treats a listed condition.
At Críonna Health we write a good deal about the parts of Irish healthcare that depend on you knowing they exist. A fifty-year-old list of sixteen conditions, quietly saving some households several hundred euro a year while passing others by entirely, is about as clear an example as you could ask for.
This article is general information, not medical or financial advice. Scheme rules, thresholds and charges change, so confirm current details with the HSE, Citizens Information or your pharmacist before making decisions.
📷 Photo by National Cancer Institute on Unsplash
