As most of you may be aware, the Health Amendment Act of 1996 set out the legal framework for a range of healthcare services to be established and provided to all men, women and children who had been infected with Hepatitis C as a result of administration within the State of contaminated blood and blood products. All men, women and children infected with Hepatitis C via contaminated blood and blood products are entitled to a Health Amendment Act (HAA) card which gives them access on a statutory basis to a wide range of primary care and hospital-based services.
The HAA card is one of the most important cards awarded by the HSE, as it gives entitlement to a range of services for the lifetime of the cardholder. It is completely separate to the medical card, GP visit card and Drug Payment Scheme (DPS) card. If HAA cardholders already have private health insurance, they may wish to retain this also as hospital services covered with the HAA card are within the public hospital setting only.
Once you are awarded the HAA card, you will also be assigned a Hepatitis C Liaison Officer within the HSE area where you live. Their role is to ensure you can access all of the health services to which you are entitled to and also to provide you with information, advice and assistance in relation to service providers. For example, your Liaison Officer can assist you in locating a dentist, physiotherapist or chiropodist in your area and will make arrangements for them to be paid for, providing you with care. If you wish to have your entitlements administered by a Hepatitis C Liaison Officer outside of the area where you live, that can be arranged for you. It is very important that you keep in contact with your Liaison Officer about any queries or concerns that you might have. They are there to support and assist you and above all, any information discussed or exchanged between you remains completely confidential.
Within the community setting i.e. outside of hospital, as a HAA card holder, you are entitled to the following:
- GP services
- all prescribed drugs
- aids and appliances
- dental services
- optical and aural services
- home support
- home nursing
- complementary therapies
You will need to produce your card when accessing services in some cases, particularly if you have not attended the service before. However, the best advice is to keep your card with you at all times in case you are asked to produce it. Your HAA card has a unique 6-digit number beginning with the letter R e.g. R98765. This number is used by the HSE in order for us to reimburse the service providers providing you with care.
In the case of GP services, you are entitled to attend any GP of your choosing free of charge. The GP can then claim reimbursement from the HSE.
All prescribed drugs and medications once on a prescription, are provided to you free of charge. Again, the pharmacist claims reimbursement from the HSE. The HAA cardholder should not be prevented from receiving any prescribed drugs and medications which they are entitled to receive. If you run into difficulty, contact your Liaison Officer.
Chiropody services are provided free of charge. You do not need a referral and can attend whenever you need to do so. Your Hepatitis C Liaison Officer can provide you with details on chiropodists in your area or alternatively you can attend a chiropodist of your choice once you have given us copies of their qualifications as they need to be accredited to one of the accrediting bodies for chiropodists. Further details can be found in the guide to services.
Counselling services are provided without charge to all HAA cardholders and also their immediate relatives. The Hepatitis C Liaison Officer in your area will provide you with details of counsellors in your area or alternatively you can attend a counsellor of your choice. It is required that the counsellor of your choice be accredited to certain professional bodies and further details on this can be found in the guide to services or by speaking to your Liaison Officer.
All routine and emergency dental treatments are covered without charge with the HAA card and we try to encourage cardholders to attend dentists already on contract to the HSE via the DTSS (Dental Treatment Services Scheme). However, if you have been attending a dentist, not on contract to the HSE and wish to continue doing so, you should talk to your Liaison Officer who will be happy to assist you in continuing care with your dentist. Cosmetic type dental treatments are not covered, however, full details on dental entitlements are covered in the guide to services and any questions you have should be referred to your Liaison Officer.
Physiotherapy services provided by chartered physiotherapists are covered by the HAA card. Your Liaison Officer will give you details of physiotherapists in your area and further details on physiotherapy services are outlined in the guide to services book.
Aids and appliances are covered by the HAA card and these must be prescribed by your GP, Consultant, Occupational Therapist or Public Health Nurse/Clinical Nurse Co-ordinator. There are many different aids and appliances used nowadays by people to assist them inside and outside their home with mobility, movement etc. These include walking sticks and frames, wheelchairs, grab rails, shower seats, bath and bed hoists etc. Depending on your need, the GP/Consultant/Occupational Therapist will decide what suits you best. Further information on what is covered by the HAA card and how to access aids and appliances is available from your Liaison Officer.
Complementary therapies currently covered under the HAA card are reflexology, aromatherapy, massage, acupuncture and hydrotherapy. HAA cardholders need to be referred by their GP/Consultant in order to avail of this service and the Hepatitis C Liaison Officer will either arrange to pay the therapist directly on your behalf or else will reimburse you on production of receipts etc. Only complementary therapists who are already registered as general practitioners (i.e. RGN’s, GP’s, Chartered Physiotherapists or for reflexology, Chiropodists) can work with HAA cardholders. You may attend a therapist who is not qualified in one of these professions if you wish, but your card will not cover you. If you are unsure about whether or not your therapist of choice can be used, you should speak with your Liaison Officer. Please speak to your Liaison Officer in relation to the maximum number of therapies you are entitled to, in any given year.
Optical services are provided to all HAA cardholders and cover any optical services, which are clinically necessary, including the cost of your eye examination and whatever lenses you are prescribed. As a HAA cardholder, you are entitled to choose frames up to a value of €90 and anything above that cost you will be liable for yourself. Whatever lenses you require are covered also. If you wear bifocals or varifocals, there is a maximum grant of €250 (including frames) which you are allowed per pair and if the cost is more than this as a result of the lenses being more expensive, you will have to pay the balance to the optician and seek reimbursement from the Liaison Officer. The grant of €250 should be sufficient to cover the full cost of a pair of varifocals. You are entitled to two pairs of glasses every two years; however, if your prescription changes within the two years, you are entitled to new glasses. Contact lenses are also fully covered if there is a clinical reason why you need to wear them. However, if you wear them by choice you will only get an initial supply every two years. For further details on this and all aspects of the optical services covered, please refer to the guide to services and of course speak with your Liaison Officer.
Access to a Home Support Service is available to all HAA cardholders who require assistance in carrying out their normal household duties and this can mean many different things depending on the needs of each individual person. Please contact your Liaison Officer in relation to home support and a home assessment can be organised for you as soon as possible.
What about hospital services?
Hospital services are available to HAA cardholders through the eight designated units which have been set up especially to look after hospital-based care for individuals infected with hepatitis C. There are very specific entitlements attached to your hospital care including a designated hepatology clinic, which takes place on days set aside for HAA cardholders only. The entitlements within the hospital setting in summary are as follows.
Open access to hospital facilities for hepatitis C or any related condition, including the right to a public hospital bed without charge.
HAA cardholders should not have to wait more than two weeks for an appointment with their liver specialist and also for the first referral to another specialty, this is generally referred to as the “two week rule”. Once a patient is referred by the Liver Consultant to another Consultant in a public hospital for the testing, investigation or treatment of any condition, they have to be given a first appointment within a 2 week period. Delays with this should be explained to you and should you have any queries regarding the timeframe in which your appointment is being arranged, you should speak to the hepatology nurse in your hepatology unit.
There are some important points which should be remembered by you for the future:
- Know who your Hepatitis C Liaison Officer is in you area.
- Any queries/concerns regarding entitlements should be discussed with your Liaison Officer.
- Information discussed with Liaison Officers remains completely confidential.
- Your HAA card is awarded for your lifetime and is a very valuable card.
- If you lose your HAA card or change address, it is important that you notify your Liaison Officer immediately as your R number will be cancelled and you will be issued with a new one.
- You should not have to resolve any difficulties yourself or explain your entitlements to any healthcare professional and the HSE will make every effort to ensure that all HAA cardholders are afforded this courtesy.