You can apply for the Long-Term Illness Scheme by post.
Download an application form:
Complete the form and post it to:
Long-Term Illness Scheme,
Client Registration Unit,
PO Box 12962,
Dublin 11,
D11 XKF3
If you cannot download the form:
- phone 0818 224 478 to order one over the phone
- get a form for your local local health office
What to include in your application
You'll need to provide your:
- full name
- date of birth
- sex
- PPS number
- address
- contact details
- proof of address
Your doctor or consultant will need to sign the form and provide a medical report.
On the form, they will list any:
- long-term illness conditions you have
- medication and appliances you need to treat your condition
Information:
Incomplete applications take longer to process. This is because we may need to contact you for more information.