13 Jul 2026
Navigating long term care in Ireland can feel overwhelming, especially when finances and family assets are involved. The fair deal scheme ireland is designed to remove that burden by ensuring you only pay what you can reasonably afford for nursing home care, while the State picks up the rest. This guide breaks down exactly how the nursing home support scheme works, who qualifies, what it costs, and how to protect your family home and savings along the way.
The fair deal scheme (formally the Nursing Home Support Scheme or NHSS) is an Irish government program for long-term nursing home care, means-tested and run by the health service executive (HSE).
You pay an assessed contribution based on income and assets, and the HSE pays the balance of approved long term care costs across public, private, and voluntary nursing homes.
The application process takes 6–8 weeks on average, may be longer in complex cases, and state support only starts from the official approval date.
Property and other assets are included in the financial assessment but are subject to protections like the 3-year cap and the optional nursing home loan (ancillary state support).
Get advice early if there is a family home, farm, business, or any gifts or transfers made in the last 5 years, as these can all affect your assessed contribution.
The fair deal scheme was created under the Nursing Homes Support Scheme Act 2009 to make nursing home care affordable and accessible to individuals in need of long term care in Ireland. It is sometimes called the "Fair Deal" or "NHSS" and is separate from a medical card or other supports that may cover additional healthcare costs.
Under the deal scheme, you contribute what you can reasonably afford after a financial assessment, and the State covers the remaining cost of approved care. The scheme is administered by the health service executive hse and applies to approved nursing homes across the country, whether they are public, private, or voluntary. The Fair Deal Scheme supports over 30,000 people in Ireland today.
The basic principle works like this:
Your contribution is based on income and assets, calculated through a formal means test.
There are clear financial safeguards so you are not left unable to meet everyday expenses.
The state pays the difference between your contribution and the actual cost of your approved care.
Eligibility for the fair deal scheme rests on two pillars: care needs and financial circumstances, not simply age. You must be ordinarily resident in Ireland and medically assessed as needing long term nursing home care, not just short term care or respite.
While most applicants are over 65, younger adults can also qualify if they require continuous nursing home level care. You must qualify for nursing home care to receive state support. Typical situations where the scheme may apply include:
Progressive dementia or cognitive decline
Significant mobility issues or high falls risk
Complex medical conditions needing 24-hour supervision
Severe physical disability requiring ongoing nursing and personal care
People already in a private nursing home can still apply. If approved, funding will only start from the HSE approval date and is not backdated to when you first entered care.
Here is a simple example of how the fair deal scheme works. Suppose a nursing home charges a weekly cost of €1,200. After your financial assessment, your assessed contribution is €400 per week. The hse pays the remaining €800. That split holds for as long as you remain in an approved nursing home and your financial situation stays the same.
Once your weekly contribution is set, it normally stays fixed regardless of which approved nursing home you choose, provided fees remain within the contract rate. You can change from one approved nursing home to another, and your assessed contribution follows you.
The scheme covers core long term care costs, including:
Accommodation and bed
Nursing and personal care
Basic health and personal services
Standard laundry service and meals
Going into the scheme does not transfer ownership of your property or savings to the State. Instead, it creates a structured obligation to pay a percentage of your income and assets.
The application process involves a formal application form plus two assessments (care needs and financial), with the option to apply for ancillary state support at the same time.
Here are the main steps:
Obtain and complete the nursing home support scheme application form.
Submit it with identity and financial documents to your local Nursing Homes Support Office.
Undergo a Care Needs Assessment.
Complete a financial assessment.
Receive HSE confirmation of your support amount and weekly contribution.
If the person applying lacks decision making capacity, a "specified person" can complete and sign the application form. This might be someone with enduring power of attorney, a decision-making representative, or a close family member. The Assisted Decision-Making (Capacity) Act 2015 clarifies who may act in this role.
The application process takes 6–8 weeks on average. The HSE will notify you of your application status within 10 working days. In complex cases involving property titles or capacity issues, processing can take longer, so apply as early as possible. You can indicate on the application form if you wish to apply for the optional nursing home loan at the same time, or you can apply for the loan at any stage while in care.
The Care Needs Assessment decides whether nursing home care is clinically appropriate or whether home-based community support could meet your needs instead. You must complete a Care Needs Assessment for eligibility.
Healthcare professionals conduct the Care Needs Assessment. This is typically carried out by a public health nurse, geriatrician, GP, or multidisciplinary team, and may involve a home or hospital visit plus review of medical reports. A physical examination and review of your current supports are usually part of the process.
The assessment evaluates daily living abilities and available supports, including:
Ability to manage daily activities (washing, dressing, eating)
Mobility and falls risk
Continence
Cognition and mental health
Availability of family and community support
The outcome is a written report stating whether long term nursing home care is approved. A report from the assessment is provided to the HSE within 10 days. The Care Needs Assessment determines if nursing home care is necessary before any financial support under the scheme can begin. If it finds residential care is not yet needed, you can be signposted to community services and can reapply if certain circumstances change.
A financial assessment determines your contribution to care costs. It is the means test that looks at your income and assets to work out a fair weekly contribution, with the hse pays the rest.
Income included in the assessment:
State pension and social welfare payments
Occupational and private pensions
Employment income
Rental income (with updated 2024 rules for principal residence)
Dividends, distributions, and other total income sources
Asset categories assessed:
Savings, deposits, and cash assets
Investments, shares, and non cash assets
Additional properties or land
Principal residence (subject to the 3-year cap)
Farms or businesses (under certain conditions)
Other assets such as certain assets gifted or transferred within 5 years
The standard contribution rates are:
| Single Person | Couple (one in care) | |
| Income contribution | 80% of assessable income | 40% of combined income |
| Asset contribution | 7.5% of assets per annum | 3.75% of combined assets per annum |
| Asset disregard | First €36,000 exempt | First €72,000 exempt |
You pay 80% of your income towards nursing home care costs if you are a single person. The first €36,000 of assets are exempt from assessment for singles, and €72,000 for couples. The disregard is taken from cash assets first before non cash assets.
Allowable deductions include income tax, PRSI, Universal Social Charge, medical expenses, maintenance payments, and property tax.
Gifts or transfers of property, land, or money in the 5 years before applying (and up to 5 years after) can still be counted in the financial assessment, limiting last-minute planning.
Contributions differ significantly for single applicants and couples. Worked examples help make the financial assessment easier to understand.
Single person example: Weekly income of €240.30, home valued at €200,000, no savings. The income contribution is 80% of €240.30 ? €192.24 per week. The asset contribution is 7.5% of the home value above the €36,000 disregard (€200,000 ? €36,000 = €164,000 × 7.5% ÷ 52) ? €236.54 per week. Total weekly contribution ? €428.78. After three years in care, the home drops out of the assessment and the contribution falls to approximately €192 per week (income only).
Couple example (one spouse enters care): Combined weekly income €800, combined cash savings €100,000, home valued €200,000. Couples pay 40% of their combined income towards care costs: €320 per week. The asset contribution is 3.75% of savings above €72,000 (€28,000 × 3.75% ÷ 52) ? €20.19 per week, plus 3.75% of property value (€200,000 × 3.75% ÷ 52) ? €144.23 per week. Total ? €484.42 per week. The spouse at home must be left with at least 50% of the couple's income.
The 3-year cap limits asset contributions to 22.5% of the value of the principal residence for a single person, and couples pay a maximum of 11.25% over three years. After 3 years, no further payments are required on homes, farms, or qualifying businesses. The primary residence is assessed for only three years, and your home is excluded from financial assessment after three years. The cap applies whether or not a nursing home loan is taken.
Since February 2024, rental income from letting your principal residence while in a nursing home is fully exempt and no longer assessed as income under the scheme.
The scheme does not cover short-term care or additional service fees. Here is what fair deal cover includes and what remains your responsibility.
Nursing and personal care
Bed and board (accommodation and meals)
Basic therapies provided by the nursing home
Laundry service (standard items)
Standard aids and appliances needed within the home
Hairdressing and personal grooming services
Newspapers, magazines
Private TV or phone bills
Certain therapies not included in the home's standard offering
High-cost specialist equipment
Some social or recreational activities
These extra fees must be set out clearly in the nursing home contract. Ask for a written breakdown of covered services versus optional extras before signing any agreement.
Additional healthcare costs like gp visits, medicines, or hospital treatments may be supported by other schemes such as the medical card or Drugs Payment Scheme. Review your entitlements alongside Fair Deal.
The optional nursing home loan (also called ancillary state support) lets you defer the asset-based part of your contribution, usually against your home, land, or other property. You can defer asset contributions using the nursing home loan so you do not have to sell or deplete your assets during your lifetime.
Under this arrangement, the HSE pays the 7.5% (or 3.75% for couples) annual asset contribution on your behalf. The loan is registered as a charge on your property, similar to a mortgage. The nursing home loan allows deferring asset contributions until death, and the loan can be deferred if a partner or life partners still live in the home.
Repayment of the loan is made to the revenue commissioners after death or on sale or transfer of the property, typically through the estate. The net proceeds of any sale are used to settle the amount owed.
You can apply for the loan during the application process or at any stage while in care. Consent from joint owners, a former spouse, or life partners is usually required.
Certain products such as a life loan or equity release mortgage from the central bank regulated market can complicate or prevent access to the nursing home loan. Professional advice is recommended before entering any such arrangement.
The scheme includes statutory financial safeguards so that applicants and their spouses are not left destitute by nursing home fees.
You will not be charged more than the actual cost of care agreed between the HSE and the approved nursing home. Overpayments are not allowed.[NA1]
A personal allowance ensures you keep at least 20% of your income or 20% of the maximum State Pension (Non-Contributory), whichever is higher, for personal spending.
Spouses or partners at home retain at least 50% of the couple's income and can continue to live in the family home. Where a nursing home loan is in place, repayment is often deferred until after the surviving partner's lifetime.
Farms and businesses can qualify for the 3-year cap, with specific protections where a successor or dependent child is actively involved.
The scheme provides financial assistance to ensure you and your family members are not left without resources for daily life.
Many Fair Deal applications are made by adult children or other relatives because the person needing care cannot manage the paperwork themselves.
A "specified person" can legally sign the application form. Typical roles include:
Decision-making representative under the Assisted Decision-Making Act
Enduring power of attorney holder
Court-appointed committee member
Spouse, civil partner, or adult child
A specified person must act in the best interests of the applicant and may need to provide evidence of their authority. There is no fee to apply, and the HSE Nursing Homes Support Office can help with queries about who is eligible to act on someone's behalf.
Keep clear written records of all decisions, contributions, and communications, especially where capacity is an issue or several family members are involved.
Fair Deal decisions interact with tax, inheritance, and overall retirement planning, so early thought can prevent problems later.
The 5-year "look back" rule means gifts of money, land, farms, or property made within 5 years before applying can still be counted as if you still owned them for the financial assessment. This applies to certain assets transferred after applying as well.
Families with significant assets, farms, or businesses should take professional advice before making large gifts, restructuring ownership, or putting properties into trust. A qualifying redress scheme or other structured financial situation may also affect assessments.
Paying privately for care, at least for a period, may benefit some high-income individuals. You can pay privately and claim income tax relief on nursing home fees at your marginal rate as a tax refund for medical expenses. A person in full time education who is a dependent child may also factor into the assessment.
Any estate and succession plan should consider likely duration and cost of long term care, the 3-year cap rules, social welfare entitlements, and how any nursing home loan will be repaid from the estate.
Here are answers to the most common questions about the fair deal scheme that are not fully covered above.
The first assessment and full processing typically take 6–8 weeks from receipt of a completed application with all supporting documents. Cases involving capacity issues, property title complications, or ancillary state support applications can take longer. State support and any nursing home loan only start from the official approval date, not the date you enter the nursing home. If you need to pay privately in the interim, keep records for any rental payments or direct fees, as these are not reimbursed retrospectively.
Yes. You can transfer to any HSE-approved nursing home that can meet your care needs, including a voluntary nursing home or a different private nursing home. Your weekly contribution remains based on your original financial assessment, and the HSE updates its payments to the new home once notified. If the new home's fees differ, any financial assistance adjusts accordingly within the approved rate.
Fair Deal funding stops when you no longer need long term nursing home care. Any ancillary state support already advanced remains repayable in line with the loan terms (on sale of property or through your estate), but no new charges accrue. A reassessment of care needs can be requested at any point, and you may be directed to home-based or community support services instead.
Fair Deal is intended for long term care only. Short term care, respite, or transitional care may be supported under different HSE schemes and are not covered under the Fair Deal financial assessment rules. If you are unsure whether your situation qualifies, speak with your GP or public health nurse for a referral to the appropriate service.
The HSE website is the authoritative source for the most up-to-date application form, information booklets, and guidance on the application process. You can also contact your local Nursing Homes Support Office or call HSELive for personalised assistance. For legal or financial advice relating to your specific financial situation, consider consulting an elder law solicitor or qualified financial planner.
Disclaimer: This article is intended for general informational and educational purposes only and should not be construed as legal, regulatory, tax, business, or financial advice. While reasonable efforts have been made to ensure that all facts, figures, and data are accurate and valid as of the date of publication, no warranty or guarantee is given as to the ongoing completeness, accuracy, or currency of the information The content is based on information available at the time of publication. Regulations, government policies, market conditions, and service offerings may change over time and vary across jurisdictions and providers. As a result, some information may no longer be current or applicable. Readers should independently verify all information and consult qualified professional advisors before making any financial, legal, or business decisions.
