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Frontier Workers – Health Entitlements

One of the key obstacles to mobility faced by many frontier workers and their families is access to healthcare. With differences in both legislation and provision it can be of no surprise that much confusion exists over the health care that frontier workers are entitled to.  

Under EU regulations a frontier worker can be defined as someone who lives in one member state and works in another, returning home at least once a week. Therefore people who live in the Republic of Ireland (ROI) and work in Northern Ireland (NI) and vice versa are considered frontier workers.

Generally, frontier workers are entitled to access health services both where they live and where they work. Therefore a frontier worker living in the Republic of Ireland will be entitled to access health services on either side of the border. However this right does not extend to dependants who are only covered under the legislation of the state in which they reside. In the Republic of Ireland, under EU Regulations, frontier workers and their dependants are automatically entitled to an Irish medical card without a means test provided they don’t have any additional income in the Republic. However, if the spouse is employed or self-employed in the Republic of Ireland or in receipt of an Irish Social Security payment they loose their automatic entitlement to this card and are subject to a means test where both their income and the income of the frontier worker are assessed and taken into account.

Frontier workers are also entitled to access maternity services in either jurisdiction. For example, a woman working in Northern Ireland and living in the Republic of Ireland is entitled to access NHS maternity services and post-natal care in Northern Ireland, effectively enabling her to choose which side of the border to have her baby. However, after appropriate post-natal care the child will not be able to access NHS services on a routine basis. It is advisable to contact the Business Services Organisation in Northern Ireland for practical information on post-natal care.

Frontier workers living in Northern Ireland and working in the South may be entitled to a medical card in the Republic of Ireland but this is subject to a means test.  They must apply in the usual way by contacting the Health Service Executive. Further information is available online at www.hse.ie. However, as these workers remain resident in Northern Ireland they will continue to be eligible to access NHS health services. It is therefore unusual for frontier workers living in Northern Ireland to apply for a medical card in ROI because entitlement is means tested.