There are several types of HSE charges and that will depend on your circumstances and what service from the HSE you use. I have listed below the most common charges.
Out-patient and Accident & Emergency Charges
If you attend the out-patients department or A+E of a public hospital, you may be charged a standard fee of €100. If you have been referred by your doctor and show the referral letter, you can receive a waiver of the €100 fee. You should also note that return visits in relation to the same illness or accident will not be subject to any additional charge.
Daily In-patient charges in public hospitals
If you stay overnight as a public patient in a public hospital, you are an in-patient. You will be charged a fee of €75 per night, up to a maximum of €750 in one year. If you are admitted to the hospital and are under the care of a consultant and discharged without staying overnight, you may still have to pay day service charges.
Private patients in public hospitals
If you choose to be treated as a private patient when you are admitted to a public hospital you are charged for the inpatient services according to the category of the hospital and (for an overnight stay) according to the type of room you are in.
All public hospitals must levy the private in-patient charge on all in-patients who opt to be treated privately by their consultant. You will also have to pay for the services of any other consultant who is involved in caring for you (for example, the radiation oncologist or anaesthetist).
Long Stay Charge
The HSE or an agency/service provider on behalf of the HSE can levy a charge on persons in receipt of long stay in-patient services. In-patient services are provided in hospitals, nursing homes or residential services for people with disabilities. The long stay charge is sometimes also called the in-patient charge.
The levy applies to
(a) persons residing in a long stay institution, or
(b) persons with an intellectual, physical or mental disability residing in community type residences where nursing or medical care is provided.
There are two classes of long stay charge:
Class 1 refers to people in receipt of in-patient services on premises where nursing care is provided on a 24 hour basis on those premises. In this case, a weekly charge, based on income bands, up to a maximum of €175.00 per week can be levied.
Class 2 refers to people in receipt of in-patient services on premises where nursing care is not provided on a 24 hour basis on those premises. In this situation, a weekly charge, based on income bands, up to a maximum of €130.00 per week can be levied.
Exemptions
Typically a person with special needs will be in receipt of Disability Allowance and have a Medical Card. This will give them an exemption from paying the Out-patient, A&E and Daily In-patient charges.
However, the Medical Card does not provide any exemption from paying the charges of the Long Stay Charge.
If your son or daughter is residing in a long stay institution or residing in the community type residence where nursing or medical care is being provided then expect most of their €188 per week from their Disability Allowance to go to the HSE.
This is just another reason why I am always advocating for parents to set up a Special Needs Trust. It allows your child to maintain all their benefit such as Disability Allowance and a Medical Card and it just gives people with additional needs more options and less reliant on the Government or HSE.