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Documents to include with a medical card application

Income, savings and assets

Wages

Provide a copy of a recent payslip dated within the last 3 months with year-to-date figures and deductions.

If you have ceased employment, provide details of the ceased employment. You can print this from the ‘myAccount’ section of revenue.ie.

State Pension

If you get a state pension, state how often you get it and amount on your application.

Include a recent copy of one of the following:

  • letter from the Department of Social Protection stating pension amount
  • bank statement showing pension payments

Occupational or private pension

For a private or occupational pension, provide a copy of a recent pension payslip, dated in the last 12 months.

If you get more than 1 pension, provide details of all pension payments.

If your pension is no longer being paid, provide a copy of a letter from your provider confirming this.

If your pension was paid as a lump sum, provide a letter from your provider with the details.

For a joint application, if your spouse or partner is also in receipt of a pension, provide payment details.

Social Welfare Payment

Please state the frequency and amount on your application.

Illness Benefit or Maternity Benefit

Provide a copy of a letter from your employer to confirm if they will continue to pay you while on this benefit.

Self Employment

If you are a sole-traders or business owner, provide copies of your most recent Income Tax Return Form 11 and all pages of your Notice of Assessment (NOA).

If your business has recently stopped trading, provide the date you stopped trading.

If your business is open less than one year, provide a copy of the set of accounts signed off by your accountant.

If Revenue has stated you have no net tax liability, provide a copy of the set of accounts signed off by your accountant or if your income from self-employment is listed on your balancing statement, submit a copy of your P21 form.

Income from Savings and Investments

Provide 1 of the following:

  • copies of any statements dated within the last 12 months from each institution stating the current balance on your accounts
  • copies of certificates of interests for all accounts you have

If you have stocks or shares, provide a copy of current share certificate statement detailing these items.

You can request the actual rate of interest to be applied to all your savings and investments. For this, provide copies of individual certificates of interest for all savings accounts.

Maintenance Payments

Provide 1 of the following:

  • a copy of the maintenance agreement or court order, dated within the last 12 months
  • a copy of a bank statement with account holders name and references to payments

Additional property

If you, or a spouse or partner, own a property or land other than your primary residence, provide details.

If the property or land is not rented, provide a valuation.

If the property or land is being rented, provide a copy of the tenancy agreement.

If you are paying a mortgage on this property or land, provide a copy of your recent mortgage account statement.

Expenses

Rent Payments

If you are renting, provide a copy of 1 of the following:

  • current tenancy agreement
  • a letter from your landlord stating your name, how much rent you pay and how often you pay it
  • rent book dated in the past 6 months with tenant’s and landlord’s name and at least 3 payments in a row signed by the landlord
  • housing assistance payment (HAP) agreement
  • a letter from your local authority stating what portion of rent you pay, if you pay a differential rent

Mortgage Payments

Provide copies of documents showing mortgage payments.

Submit a copy of one of the following:

  • your mortgage statement
  • letter from your mortgage provider showing 3 payments, 1 within the last 3 months
  • bank statement, showing you as the account holder and referencing mortgage payments

Mortgage protection Insurance or mortgage life assurance premium

Provide a copy of a letter from service provider confirming payment for this insurance type, and confirmation that this insurance is connected to your mortgage.

Childcare costs

Please provide:

  • a copy of the letter from childcare provider confirming the amount you pay each week
  • name, address and telephone number of your childcare provider

Travel to work costs

If you travel to work, provide the address of your employment and the distance you travel to work.

If you drive to work, provide the distance you travel and a copy of your Vehicle Registration Certificate.

If you use public transport, provide copies of your bus or train tickets.

Maintenance Payments

Provide 1 of the following:

  • a copy of the maintenance agreement or court order, dated within the last 12 months
  • a copy of a bank statement with account holders name and references to payments

Nursing home costs

Provide a copy of an invoice from the nursing home.

Page last reviewed: 20 January 2023