What to Do After a Serious Diagnosis in Ireland

A serious diagnosis arrives with an overwhelming number of questions about treatment, work, and money. Almost none of them need answering today. This guide covers the practical steps in roughly the order they tend to matter, so you can take them one at a time. If you'd rather have a plan built around your situation, answer a few questions and we'll build one around you →

First, get the picture clear

Your GP is your first point of contact and the gateway to specialist care under the public health system. If your GP suspects something serious, they will refer you to a consultant at an HSE hospital or clinic. Public patients are seen in order of clinical priority; for suspected cancers and other urgent conditions, referrals are flagged as urgent and tracked under the National Cancer Screening Service pathways and HSE rapid access clinics where available.

Once you're under a consultant, ask them to write down your diagnosis, the proposed treatment plan, and the likely timeline. Ask who is coordinating your care — many conditions have a clinical nurse specialist (CNS) or key worker who acts as your main contact between appointments. Write down their name and direct number.

If you hold private health insurance — through insurers such as VHI, Laya Healthcare, or Irish Life Health — you may be able to access a consultant faster as a private or semi-private patient, either in a private hospital or in a private bed within an HSE hospital. Check your policy and pre-authorise any treatment before attending to confirm cover. Public and private routes can sometimes be combined depending on your circumstances.

You are entitled to seek a second opinion. Ask your GP or consultant to arrange one; this is routine and won't cause offence. Where you can, take someone with you to appointments — a second set of ears is invaluable when absorbing difficult information. A written list of questions beforehand helps you use the time well.

Medical Card and GP Visit Card

A Medical Card entitles you to free GP visits, prescribed medicines, dental, optical, and aural services, and other HSE services. It is means-tested based on income and household size. Apply online through mymedicalcard.ie or through your Local Health Office. If your income exceeds the threshold, you may still qualify for a discretionary Medical Card — the HSE can grant these on hardship or serious illness grounds regardless of income, particularly where medical costs are placing significant financial pressure on a household. Ask your GP or social worker about this option, or apply directly to the HSE.

A GP Visit Card covers the cost of GP visits only (not prescriptions or other services) and has a higher income threshold than the Medical Card. If you don't qualify for a Medical Card, check whether you qualify for a GP Visit Card at citizensinformation.ie.

Long-Term Illness (LTI) Scheme

The Long-Term Illness Scheme provides free drugs, medicines, and medical appliances to people with certain specified conditions, regardless of income. Conditions covered include cancer, epilepsy, diabetes, multiple sclerosis, Parkinson's disease, cystic fibrosis, haemophilia, cerebral palsy, and several others. If your condition is on the list, register with your Local Health Office — once registered, your illness-related medications are provided free of charge. See the full list and how to apply at hse.ie.

Drugs Payment Scheme

If you do not hold a Medical Card or qualify for the LTI Scheme, the Drugs Payment Scheme (DPS) limits how much you pay for approved prescribed medicines. Once your out-of-pocket medicine costs reach the monthly DPS threshold — check hse.ie for the current monthly cap, as it is set by Budget each year — the HSE covers all further costs for the remainder of that calendar month. Register your household at your pharmacy using a DPS card. The scheme covers the whole household, so costs can be pooled.

Sick pay from your employer

You decide what you tell your employer and when. You are not required to disclose the name of your diagnosis — only that you have a health condition affecting your ability to work, if and when you need to take time off or request changes to how you work.

The Sick Leave Act 2022 introduced a statutory sick pay entitlement for employees in Ireland. In 2026, you are entitled to 5 days of statutory sick pay per year, paid at 70% of your normal daily earnings, subject to a cap of €110 per day. To qualify you must have been continuously employed by your employer for at least 13 weeks, and you must provide a medical certificate from your GP from the first day of illness. Statutory sick pay does not cover the self-employed.

Many employers operate occupational sick pay schemes that are more generous than the statutory minimum — paying full salary for a period or covering a longer absence. Check your contract of employment or speak to your HR department to understand what you're entitled to and for how long.

Illness Benefit — when employer sick pay ends

Illness Benefit is a weekly payment from the Department of Social Protection (DSP) for people who cannot work due to illness and have sufficient Pay-Related Social Insurance (PRSI) contributions. It is not means-tested.

To qualify you generally need: at least 104 weeks of PRSI contributions paid since you first started work, and at least 39 weeks of PRSI paid or credited in the relevant tax year (two years before the current benefit year), of which at least 13 must be paid contributions (not credits). Check the detailed PRSI contribution requirements at gov.ie or through citizensinformation.ie, as the rules can be complex.

Illness Benefit is paid from day 6 of illness for most employees (SSP covers the first 5 days; the traditional 3 waiting days and day-4 start apply only once SSP entitlement for the year is exhausted). You must provide a medical certificate of illness from your GP. The weekly personal rate changes each year with the Budget; check gov.ie for the current amount. Illness Benefit can be paid for up to two years (104 weeks).

Illness Benefit typically follows on from your employer sick pay period — you can claim it once you're no longer receiving full pay from your employer (or immediately if you have no occupational sick pay). Apply through MyWelfare.ie or by contacting your local DSP office.

Invalidity Pension — for long-term incapacity

The Invalidity Pension is a weekly PRSI-based payment for people who are permanently incapable of work, or who have been incapable of work for at least 12 months and are likely to remain so for at least another 12 months. It pays a higher personal rate than Illness Benefit and also entitles you to a free travel pass and, after a period, the Household Benefits Package.

To qualify you must have at least 260 weeks of PRSI contributions paid since starting work and at least 48 weeks of PRSI paid or credited in the year before you claim (or the year before that). You must also satisfy the medical criteria — that your incapacity is permanent or expected to be long-term. Apply through DSP via MyWelfare.ie. If you have been on Illness Benefit for 12 months, DSP may contact you about transferring to Invalidity Pension; you can also apply directly.

Disability Allowance — means-tested, long-term

Disability Allowance is a weekly means-tested payment for people aged 16 to 66 with a disability expected to last at least one year, where that disability substantially restricts the person's ability to undertake suitable employment. Unlike Illness Benefit and Invalidity Pension, it does not require PRSI contributions — it is assessed on income and assets instead.

Secondary benefits can include Free Travel and the Household Benefits Package. Disability Allowance is not affected by your impairment being in work — you can work and continue to receive a reduced payment under certain income thresholds. Apply through MyWelfare.ie or at your local DSP Intreo Centre.

Partial Capacity Benefit — returning to some work

If you are receiving Illness Benefit or Invalidity Pension and want to return to work or self-employment despite having a reduced capacity to work, Partial Capacity Benefit allows you to do so while continuing to receive a payment from DSP. The payment is set at 50%, 75%, or 100% of your existing Illness Benefit or Invalidity Pension rate, depending on the assessed degree of restriction on your capacity. You need to have been on Illness Benefit for at least 6 months, or to be on Invalidity Pension, before applying. Apply through DSP.

Support for your carer

If someone close to you is providing care while you are unwell, they may be entitled to support from DSP.

• Carer's Allowance — a means-tested weekly payment for people who are providing full-time care and attention to someone who needs it continuously. The person being cared for must require this level of support due to age, disability, or illness.
• Carer's Benefit — a PRSI-based payment for employees or the self-employed who take time off work to provide full-time care. It is paid for up to 2 years (which can be taken in separate periods). The carer must have at least 156 weeks of PRSI contributions paid.
• Carer's Support Grant — an annual grant paid automatically to carers who are receiving Carer's Allowance, Carer's Benefit, or Domiciliary Care Allowance. It can also be claimed directly by carers who are not receiving those payments but meet the eligibility criteria. Check the current grant amount at gov.ie.

Carers can get information and support from the Care Alliance Ireland and through Citizens Information.

Your pension

If you belong to an occupational pension scheme through your employer, contact your scheme's trustees or pension administrator and ask whether the scheme has ill-health early retirement provisions. Many defined benefit and defined contribution occupational schemes allow members to access pension benefits before normal retirement age if they are permanently incapable of carrying out their job. The Revenue Commissioners permit early payment of occupational pension benefits on ill-health grounds. Ask for the rules in writing, as conditions and benefit levels vary significantly between schemes.

If you hold a Personal Retirement Savings Account (PRSA) or a personal pension plan, the rules on early access in cases of permanent incapacity vary by policy — ask your pension provider. Ordinarily, personal pensions can be accessed from age 60.

When you are receiving certain DSP payments — including Illness Benefit and Invalidity Pension — you continue to accumulate PRSI credits, which count towards your State Pension (Contributory) record. Confirm with DSP that credits are being applied to your record. You can check your PRSI contribution history through MyWelfare.ie.

Before drawing down any pension early, consider taking advice from a regulated financial adviser. Check the Central Bank of Ireland register at registers.centralbank.ie to confirm that any adviser you consult is authorised.

Check your insurance

Before doing anything else with your policies, do not cancel or change any cover while you're checking — some policies pay out on diagnosis itself, and cancelling could forfeit an entitlement that already exists.

• Income protection insurance (sometimes called Permanent Health Insurance in Ireland) — replaces a portion of your income if you are unable to work due to illness or injury. Check the deferred period (the waiting period before payments start — commonly 13, 26, or 52 weeks) and whether your employer provides a group income protection scheme that you may already be enrolled in.
• Specified illness cover (also called serious illness cover or critical illness cover) — pays a lump sum on diagnosis of a listed condition, regardless of whether you can still work. Conditions covered and their definitions vary between policies, so read the policy schedule carefully and contact your insurer directly.
• Mortgage protection insurance — in Ireland, lenders are required by law to ensure that mortgage borrowers have life assurance cover in place. Many mortgage protection policies are death-only, but some include a serious illness or disability element. Check your policy documents and contact your insurer or broker to understand what your policy covers.
• Life insurance with a serious illness benefit — some life policies include an accelerated serious illness benefit that pays out a portion of the sum insured on diagnosis of a listed condition. Check your policy terms.

If you are unsure which policies you hold, check old payslips for group scheme deductions, and contact your HR department about employer-provided cover. Check also with any previous employers' pension schemes, as life and disability cover is sometimes included by default in occupational arrangements.

If you have a dispute or complaint about how an insurer has handled your claim, contact the Financial Services and Pensions Ombudsman (FSPO) at fspo.ie or on 01 567 7000. The FSPO is free to use and can direct financial service providers to pay out where a complaint is upheld.

Sort the legal paperwork while you're well

Two documents are worth putting in place while you have capacity to make decisions. These aren't about expecting the worst — they're about keeping control in your own hands.

Enduring Power of Attorney

An Enduring Power of Attorney (EPA) is a legal document under the Assisted Decision-Making (Capacity) Act 2015 that lets you (the donor) appoint one or more people you trust (your attorneys) to make decisions on your behalf if you lose capacity in the future. An EPA can cover property and financial affairs (bank accounts, bills, property), personal welfare (health, care, and daily life decisions), or both — you decide the scope when you set it up.

To be valid, an EPA must be signed by you in the presence of a solicitor, who certifies that you have capacity and are not under any undue influence. The EPA must then be registered with the Decision Support Service (DSS) — the State body established under the 2015 Act — before your attorney can act on it. Notify specified persons (such as close family members) as required by the Act. Registering in advance, while you are well, means the document is in place and ready to use if it is ever needed. More information is available at decisionsupportservice.ie.

The EPA is the Irish system — do not confuse it with any other jurisdiction's equivalent. The DSS (not any other office) is responsible for registration and oversight.

Advance Healthcare Directive

An Advance Healthcare Directive (AHD), also provided for under the 2015 Act, lets you set out in writing which medical treatments you would accept or refuse in the future, if you are unable to communicate your wishes at the time. You can also use an AHD to appoint a Designated Healthcare Representative (DHR) — a person authorised to give or refuse consent to treatment on your behalf when you lack capacity. An AHD must be in writing, signed, and witnessed. It does not need to be registered, but can be. Healthcare professionals are required to respect a valid AHD. You do not need a solicitor to complete an AHD, though taking legal advice is worthwhile. The HSE and DSS both publish guidance.

It is also worth making or updating your will. A solicitor can advise on both documents at the same time.

Support and who to contact

• Citizens Information — 0818 07 4000 (Monday to Friday, 9am–8pm) or citizensinformation.ie. Free, independent information on your rights, benefits, employment, and services in Ireland. You can also visit a Citizens Information Centre in person.
• Irish Cancer Society Support Line — 1800 200 700 (free, Monday to Friday, 9am–5pm). Information and emotional support for people affected by cancer, including help navigating services and financial supports.
• MABS (Money Advice and Budgeting Service) — 0818 07 2000 or mabs.ie. Free, confidential money advice for people experiencing financial difficulty, including debt management.
• HSE — hse.ie or 1800 700 700. Information on health services, Medical Card, LTI Scheme, DPS, and HSE schemes.
• Department of Social Protection — gov.ie/dsp. Information on all DSP payments including Illness Benefit, Invalidity Pension, Disability Allowance, and Carer's supports. Apply and manage claims through MyWelfare.ie.
• Decision Support Service (DSS) — decisionsupportservice.ie or 01 211 9750. Responsible for the registration of EPAs and AHDs, and for providing information on the Assisted Decision-Making (Capacity) Act 2015.
• Financial Services and Pensions Ombudsman (FSPO) — fspo.ie or 01 567 7000. Free service for resolving disputes with financial service providers and pension schemes, including insurance claim rejections.