The National Appeals Service operates as part of National Services & Schemes and is independent of acute and community services within the HSE.
Purpose
The purpose of the National Appeals Service is to provide an independent, internal and impartial review of decisions relating to applications for specified services and entitlements, where applicants are dissatisfied with the outcome of their application/review and to determine whether the original decision may be upheld or revoked, either fully or partially in accordance with legislation and guidelines.
An appeal option is provided for decisions which are made in accordance with relevant legislation, regulations and guidelines. In some instances the option for a reassessment/review process may be provided in advance of the appeal process, however, certain timeframes will apply.
A statutory appeal service is provided for the Nursing Homes Support Scheme (NHSS) wherein appeals officers appointed from a panel, approved by the Minister for Health, make decisions as prescribed in Section 32 of the NHSS Act 2009, (as amended).
A non-statutory appeals service is provided for other eligible schemes. Appeal decisions are made by an Appeals Officer in line with the relevant legislation, regulations and guidelines for these schemes.
Aim
It is our aim to:
- provide prompt, accurate, courteous, efficient and impartial service to all of our service users.
- provide a high standard service and treat all of our service users fairly and equally.
We would ask that Service Users be equally courteous and respectful when communicating with National Appeals Service staff.
Schemes for which appeals can be made to National Appeals Service in the Health Service Executive
- Nursing Homes Support Scheme (Also known as Fair Deal Scheme) - Appeals process is operated in line with Section 32 of the NHSS Act 2009, as amended, which provides the option of an appeal in relation to a decision made under the scheme (as specified).
- Medical Cards & GP Visit Cards (GPV) including General Medical /GPV cards, Over 70s Medical/GPV cards and Cards relating to persons 16 to 25 years of age - This is operated in line with the provisions of the Health Act 1970, as amended, and relevant regulations and guidelines.
- Residential Support Services Maintenance and Accommodation Contributions (RSSMAC) - (Also known as Long Stay Contribution) - This is operated in line with Sections 67A, 67B, 67C and 67D of the Health Act 1970, (as amended) and national guidelines issued by the Department of Health.
- Nursing Home Subvention Scheme - This is operated in line with the Nursing Homes Act 1990 and Nursing Homes (Subvention) Regulations.
- Health Amendment Card for persons suffering with Hepatitis C - This is operated in line with the Health Amendment Act 1996 (as amended).
- Blind Welfare Allowance - As provided under the Blind Persons Act 1920 (as amended) and in line with National Guidelines issued by the Department of Children, Equality, Disability, Integration and Youth.
- Mobility Allowance -The Mobility Allowance was introduced in 1979 by Circular 15/79 and is payable under Section 61 of the Health Act 1970 - the scheme closed in 2013 to new applicants. Persons whom where in receipt of a Mobility allowance payment at the time the scheme closed continue to receive payment subject to meeting the eligibility criteria as outlined in the National Guidelines issued by the Department of Health.
Overseas Treatment Schemes
The HSE National Appeals Service began accepting appeals in relation to the Overseas Treatment Schemes in January 2025. In order to appeal you must be in receipt of a decision letter from the Overseas Treatment Schemes office advising of your right to appeal to the HSE - National Appeals Service.
Schemes
Cross Border Directive Scheme entitles you to access healthcare that is publicly funded and available in Ireland, by undergoing treatment in another member state of the European Union (EU) or European Economic Area (EEA), which also includes Iceland, Liechtenstein and Norway. It is provided for under the European Union (Application of Patients’ Rights in Cross Border Healthcare) Regulations 2014, S.I. No. 203/2014 and the Cross-Border Healthcare Directive (EU Directive 2011/24/EU). You must pay for the treatment up front and then apply for reimbursement from the HSE.
Northern Ireland Planned Healthcare Scheme entitles you access healthcare that is publicly funded and available in Ireland, by undergoing treatment in Northern Ireland. This is a temporary scheme that allows you to receive healthcare in Northern Ireland in a similar way to the Cross-Border Healthcare Directive. It is provided for under the Health Act 1970 (section 75A) S.I. No 724 of 2020. The healthcare must be publicly available in Ireland. You must pay for the healthcare and then claim the cost from the HSE.
Treatment Abroad Scheme entitles you to planned treatment in another member state of the European Union (EU), the European Economic Area (EEA) which includes Iceland, Liechtenstein and Norway, or Switzerland. You must be entitled to public health services in Ireland, require treatment that is not available to you or not available to you in a timely manner in Ireland. Treatment must also be within Irish law.
If you wish to appeal in relation to an Overseas Treatment Scheme decision you should do so within three months of the written decision. This time limit may be extended where, in the circumstances of a particular case, if it is deemed reasonable to do so.
