Long-Term Illness Scheme 2026 — Free medicines for 16 conditions, no means test
Long-Term Illness Scheme Ireland 2026
If you have one of 16 qualifying long-term conditions, the HSE provides your related medicines and medical appliances completely free. No income test. No means test. Open to immigrants. Your GP or specialist handles the application. Here is the complete guide to the 16 qualifying conditions, what is covered, how to apply, and how the LTI compares to the Medical Card and Drug Payment Scheme.
Long-Term Illness Scheme 2026 — Quick facts
- Qualifying conditions
- 16 specific conditions
- Cost of covered medicines
- Free — no charge
- Means test
- None — diagnosis-based only
- Immigrants
- Yes — ordinary residence only
- Card expires
- No — valid indefinitely (most conditions)
- Apply through
- GP or specialist — 4 to 8 weeks
The 16 qualifying conditions
| Condition | Age restriction | Key medicines typically covered |
|---|---|---|
| Acute Leukaemia | All ages (during active treatment) | Chemotherapy drugs, supportive medicines during treatment |
| Cerebral Palsy | All ages | Antispasticity medicines, anticonvulsants (if epilepsy co-occurs) |
| Cystic Fibrosis | All ages | Pancreatic enzymes, inhaled medicines, CFTR modulators (Kaftrio, Symkevi where reimbursed) |
| Diabetes Insipidus | All ages | Desmopressin and related medicines |
| Diabetes Mellitus (Type 1 & 2) | All ages | Insulin, oral antidiabetics, test strips, lancets, insulin pens/needles, CGM supplies |
| Epilepsy | All ages | Anti-epileptic drugs (AEDs) for seizure control |
| Haemophilia | All ages | Clotting factor concentrates, haemostatic treatments |
| Hydrocephalus | All ages | Medicines as clinically required |
| Intellectual Disability | All ages | Medicines related to the intellectual disability and associated conditions |
| Mental Illness | Under 16 only | Antipsychotics, mood stabilisers (under-16s only) |
| Multiple Sclerosis | All ages | Disease-modifying therapies (interferon, natalizumab, ocrelizumab etc.), symptomatic treatments |
| Muscular Dystrophies | All ages | Supportive medicines, corticosteroids as prescribed |
| Parkinsonism | Under 66 only | Levodopa, dopamine agonists, MAO-B inhibitors |
| Phenylketonuria (PKU) | All ages | Phenylalanine-free formula and medical food |
| Spina Bifida | All ages | Medicines related to the condition and complications |
| Thalidomide-related conditions | Those affected by Thalidomide | Medicines related to Thalidomide-caused conditions |
What the LTI covers in practice
The LTI covers medicines and medical appliances on the HSE Reimbursement List that are directly related to your qualifying condition. Only condition-specific items are free — medicines for unrelated conditions are not covered by the LTI.
For example, a person with diabetes who also has high blood pressure: their insulin and test strips are free under the LTI, but their blood pressure medicine is a DPS item (counts towards the €80/month cap).
Your pharmacist knows exactly which of your prescriptions fall under your LTI entitlement. Ask them to confirm if you are unsure about a specific medicine.
LTI vs Medical Card vs Drug Payment Scheme
| Situation | LTI-covered medicines | Other medicines (not LTI) | GP visits |
|---|---|---|---|
| LTI card only (no Medical Card) | Free | DPS cap: max €80/month | Full private cost |
| Medical Card only (no LTI) | €1.50/item (max €15/month) | €1.50/item (max €15/month) | Free |
| LTI card + Medical Card | Free | €1.50/item (max €15/month) | Free |
| No card, no LTI | Full cost (DPS €80/month cap) | Full cost (DPS €80/month cap) | Full private cost |
Worked examples — cost savings
Example 1 — Diabetic (Type 1), 6 prescription items per month
Maria has Type 1 diabetes. Her monthly diabetes prescriptions include: insulin (2 items), test strips, lancets, insulin pen needles, and a CGM sensor. 6 items per month.
Without LTI: DPS — €80/month cap. Actual cost depends on item prices but potentially €80/month.
With LTI (no Medical Card): €0 for all 6 diabetes items — completely free.
Annual saving: up to €960/year
Example 2 — Person with MS on Medical Card, 3 LTI medicines
Carlos has MS and holds a Medical Card. His disease-modifying therapy (3 prescription items) costs him €1.50/item = €4.50/month under the Medical Card. If he also registers for the LTI, those 3 items become free.
Saving from adding LTI: €4.50/month × 12 = €54/year on those items (the Medical Card was already capping costs, so the saving is modest — but still worthwhile for zero additional effort).
Example 3 — Person with CF, high prescription costs
Ana has Cystic Fibrosis. Her monthly prescriptions include CFTR modulator therapy (Kaftrio/Symkevi — where reimbursed), pancreatic enzymes, inhaled antibiotics and other medicines. Without LTI these would cost hundreds of euros per month. With LTI, all CF-related medicines are free.
Annual saving: potentially thousands of euros
How to apply
- Tell your GP or specialist
Inform your GP, paediatrician or consultant that you want to register for the Long-Term Illness Scheme. They are responsible for completing and submitting the application — you do not submit the form yourself.
- Doctor completes the LTI application form
Your doctor completes a form confirming your diagnosis, the expected duration of the condition, and the medicines required. This is submitted to the HSE Local Health Office (LHO) for your area.
- HSE processes the application
The HSE reviews the application. Approval typically takes 4 to 8 weeks. Your doctor or pharmacist can follow up with the LHO if there are delays.
- Receive your LTI card
Once approved, you receive an LTI card from the HSE. Present this card at your pharmacy every time you collect medicines for your qualifying condition. The pharmacist dispenses those items free of charge and claims from the HSE.
What if I am refused or not registered?
If your GP submits an application and it is declined by the HSE, you can:
- Ask your GP to provide additional medical evidence supporting the diagnosis and the need for the medicines
- Request a review through the HSE Local Health Office
- Contact the HSE Medical Card office or your local Citizens Information Centre for guidance
While waiting for LTI approval, your prescriptions still count towards the DPS €80/month cap — so you are protected from very high costs in the interim.
Frequently asked questions
- You do not need a Medical Card to qualify — LTI is entirely separate and based solely on diagnosis, not income.
- Only medicines directly related to your qualifying condition are free. Prescriptions for unrelated illnesses are not covered by the LTI.
- Mental illness only qualifies for under-16s. Adults with mental health conditions cannot use the LTI for that condition.
- Parkinsonism only qualifies for people under 66. After 66, LTI entitlement under that condition ends.
- The LTI card does not expire for most conditions — no annual renewal is required.
- Even if you already have a Medical Card, register for the LTI — your LTI medicines become completely free rather than €1.50 per item.
- Immigrants can apply — only ordinary residence in Ireland is required.
Related guides
This page was reviewed against official HSE guidance. Long-Term Illness Scheme 2026: free medicines for 16 qualifying conditions, no means test, open to all ordinarily resident in Ireland. Apply through your GP or specialist.
Information Accuracy — This guide has been independently researched and reviewed using official Irish government sources available on the publication date. Government schemes, payment rates, eligibility rules and legislation may change over time. Before making financial, legal or welfare decisions, always confirm the latest information directly with the relevant Irish authority.