If your family already holds a medical card, your new baby is not simply covered by it. They have to be added to the card, and that is something you do, not something that happens in the background while you are getting used to a newborn.
It is a short job, a phone call or an email, but it has a gate in front of it: you need your baby's PPS number, and that does not exist until the birth is registered. So the order matters more than the effort does.
The short version
- Who this is for
- Families who already hold a medical card and have had a baby
- What you need
- Your baby's name, date of birth and PPS number
- How
- Phone 0818 22 44 78 or email nmcu.cod@hse.ie
- Then send
- Copies of the birth certificate and of the PPS number. Copies only
- Comes first
- Registering the birth, because the PPS number follows from it
- Who decides
- The HSE. Not your GP, and not the hospital
What a medical card actually covers
A medical card means you do not pay to see your GP, or for most of the medicines your GP prescribes. It also covers public out-patient and in-patient services, eye and ear tests and dental checks.
One thing worth knowing before you are surprised at a pharmacy counter: prescribed medicines are not quite free. Medical card holders under 70 pay a prescription charge of €1.50 for each item, up to a maximum of €15 a month. It is a small amount next to the full price of a prescription, but it is not nothing, and nobody tends to mention it.
Why the PPS number has to come first
The HSE asks for your baby's PPS number when you add them, so the sequence is fixed:
- Register the birth. You must do this within three months. After a hospital birth the advice is to wait three weeks before booking the appointment.
- The PPS number arrives on its own. You do not apply for it. A child born in the Republic is given a PPS number when the birth is registered, and if that happens within three months the number and the Child Benefit forms are posted out to you automatically.
- Add your baby to the card. One call or one email, once you have the number.
This is the part that catches people out. Parents often try to sort the medical card in the first week, find they cannot finish it, and then forget to come back to it once the PPS number does arrive weeks later. It is worth writing down somewhere you will see it.
Register within the three months and none of this applies to you. It is the legal deadline anyway, and meeting it is what keeps the PPS number automatic.
The two official pages disagree on the cut-off. Citizens Information says that after three months you have to contact Client Identity Services and the Department of Social Protection to arrange the PPS number and Child Benefit. The Department's own PPS page says the cut-off is 180 days. We have quoted both rather than pick one, and both are linked at the end of this guide.
Your child does not need to go without GP cover while you wait. The HSE says all children under eight living in Ireland can get a GP visit card, so that one does not depend on your income at all. Better still, it does not make you wait for the PPS number either: if your baby is under four months you can register them now, and the HSE will ask for the PPS number later. It is a separate card with its own registration.
How to add your baby
Phone 0818 22 44 78 or email nmcu.cod@hse.ie with your child's:
- name
- date of birth
- PPS number
You then send copies of your child's birth certificate and of their PPS number. The HSE is explicit about this: do not send original documents. Send copies and keep the originals, because you will need the birth certificate again for other things.
Have all three details in front of you before you pick up the phone. It turns the job into one call rather than two.
One condition to be aware of: Citizens Information sets this out as something you can do if you hold a medical card and you are getting Child Benefit for the child. Child Benefit follows from registering the birth, so in practice it lands in the same window as the PPS number rather than being a separate thing to chase.
If you do not have a medical card
A medical card is assessed on your income, and the HSE decides who qualifies. Nothing on this page changes that assessment or predicts it, so if you are not sure whether your family would qualify, the HSE is the place to ask rather than a guide.
Two things exist alongside it and are worth knowing about either way:
- The Under 8s GP visit card, which covers free GP visits for any child under eight living in Ireland and is not means-tested.
- The Drugs Payment Scheme, a separate HSE scheme that caps what a household pays for approved prescribed medicines at €80 a month.
There is one more route that has nothing to do with income. A child diagnosed with cancer within the last five years qualifies for a medical card without a financial assessment.
Who decides, and where to ask
Medical cards are run by the HSE, and the HSE makes every decision about eligibility and about what your card covers. Your GP does not decide it and cannot speed it up. For anything specific to your own situation, HSE Live is on 1800 700 700.
If the application stalls, or the answer is no
There are three different routes here and they are not interchangeable. Picking the wrong one costs you weeks, and the HSE says so itself: if you appeal when a reassessment was the right step, the appeals office forwards your letter back, which it warns "may delay a decision".
Which one you need depends on what you have received:
- No decision yet, just repeated requests for documents. Do not appeal. The HSE's own instruction is explicit: do not appeal "if a decision has not yet been made on an application or review of eligibility". There is nothing to appeal against. This is a service problem, so it goes to HSE Live and then, if that leads nowhere, through Your Service Your Say, which is the formal complaints process and has a clock on each stage.
- A decision you think used the wrong figures, or you have new information. Ask for a reassessment, not an appeal. Send the information that was missing. Medical reports from your GP or a hospital consultant go to a medical officer, and a card can still be granted on a discretionary basis.
- A decision you believe is simply wrong. That is the appeal, and it goes to the National Appeals Office, which is staffed by people who had no part in the original assessment.
The appeal deadline is 28 days, counted from the date on the decision letter, not from the day it reached you. The head of the National Appeals Service can extend it in some cases, but you have to ask. Appeal decisions come in writing and are never given over the phone.
The National Appeals Office is at An Clochar, Health Campus, College Street, Ballyshannon, County Donegal, F94 TPX4, and takes email at nationalappeals@hse.ie. If you disagree with the appeals officer's decision, the next and last step outside the courts is a complaint to the Office of the Ombudsman.
See this alongside everything else you have to do
parentready puts your Irish parent admin in the order it has to happen, so the steps that depend on the PPS number wait until it arrives instead of getting lost. Free, private, and on your device.
Official sources
- HSE: Change your medical card details
- HSE: What a medical card covers
- HSE: Prescription charges for medical card holders
- HSE: Medical cards
- HSE: Appeal a medical card decision
- HSE: Appeal a decision through the HSE National Appeals Service
- HSE: Drugs Payment Scheme
- HSE: Under 8s GP visit card
- Department of Social Protection: Get a Personal Public Service (PPS) Number
- Citizens Information: Registering the birth of your baby
- Citizens Information: Maternity and infant care services
Facts checked against the official pages on 28 August 2026. This is general information, not medical, legal or financial advice, and it does not decide your eligibility; the HSE makes that decision. Rules and charges can change; always confirm on the official pages linked above.