Nursing Home Support Scheme Ireland: Fair Deal Guide

When a family member needs long-term nursing home care, the financial side can feel overwhelming. Ireland’s Nursing Home Support Scheme — commonly called the Fair Deal scheme — is designed to help with those costs. This guide breaks down exactly how it works, what you’ll pay, and what happens after the first three years.

Income contribution: 80% of your income ·
Asset contribution: 7.5% per year (capped at 3 years) ·
State contribution: Balance of nursing home fees ·
Asset cap duration: Maximum 3 years ·
Scheme start year: 2009 ·
Administering body: Health Service Executive (HSE)

Six key figures define the scheme’s financial structure.

The pattern: The scheme pools personal contributions with state funding to cover the full cost, regardless of which registered home you choose.

What is the nursing home support scheme in Ireland?

What is the Fair Deal scheme?

• The scheme is also called the Fair Deal scheme (HSE (Ireland’s health service))
• It provides financial support for people in long-term nursing home care (HSE (Ireland’s health service))
• You pay part of the cost based on income and assets; the HSE pays the balance (HSE (Ireland’s health service))

Who is eligible for the Nursing Home Support Scheme?

• Must be ordinarily resident in Ireland (living here at least 1 year) (Cashin Clancy Solicitors (Irish legal advisory))
• A care needs assessment determines if long-term nursing home care is required (HSE (Ireland’s health service))
• A financial assessment calculates your contribution (HSE (Ireland’s health service))

What costs does the scheme cover?

• Accommodation and food
• Nursing and personal care (emeis.ie brochure (Irish nursing home operator))
• Laundry and basic aids
• Other goods and services may be covered under the Medical Card or Drugs Payment Scheme (emeis.ie brochure (Irish nursing home operator))

What this means: The Fair Deal scheme is the primary route to affordable nursing home care in Ireland. It pools personal contributions with state funding to cover the full cost, regardless of which registered home you choose.

What is the threshold for a fair deal scheme?

How is income assessed?

• You contribute 80% of your weekly income (HSE (Ireland’s health service))
• Income includes pensions, social welfare, and other sources

How are assets valued?

• Assets include savings, investments, and property (except the principal residence for first 3 years is partially excluded)
• You contribute 7.5% of your assets per year (Cashin Clancy Solicitors (Irish legal advisory))
• Your principal residence is included in the asset calculation for the first 3 years (HSE (Ireland’s health service))

What is the 7.5% asset contribution?

• It’s an annual charge on the value of your assets (HSE (Ireland’s health service))
• The asset contribution is capped at 3 years (HSE (Ireland’s health service))

The pattern: The more assets you have, the more you pay — but only for a limited time. After three years, the asset contribution stops, which can significantly reduce the ongoing cost for homeowners.

What happens after 3 years on the Fair Deal scheme?

What changes after 3 years?

• After 3 years, no further contribution from assets (HSE (Ireland’s health service))
• The State covers the remaining cost
• Your principal residence is no longer included in the asset calculation (HSE (Ireland’s health service))

Does the 7.5% asset contribution stop?

• Yes, the 7.5% per year charge stops after 3 years (HSE (Ireland’s health service))
• From that point, your only contribution is 80% of your income

What about the family home?

• After 3 years, the family home is excluded from the asset assessment (HSE (Ireland’s health service))
• This means your home is protected from further contributions

Why this matters: For homeowners, the 3-year cap is the single most important feature. It limits how much of your property’s value goes towards care costs, preserving more of your estate for your family.

What happens if you can’t afford a nursing home in Ireland?

What financial help is available?

• The scheme is means-tested, so the HSE calculates your ability to pay (HSE (Ireland’s health service))
• If you have little income or assets, the HSE covers the majority of the cost
• You may also qualify for additional state support like the Medical Card (emeis.ie brochure (Irish nursing home operator))

Can you get a waiver?

• There is no waiver for the Fair Deal scheme
• But the HSE covers the balance of fees after your contribution (HSE (Ireland’s health service))

What if you have no income or assets?

• The State pays the full cost of care (HSE (Ireland’s health service))
• Home care packages are an alternative if you prefer to stay at home

The trade-off: No one is turned away for inability to pay. But choosing a more expensive private nursing home may mean your contribution is higher, as the HSE only pays up to the maximum agreed price for that home.

Are there free nursing homes in Ireland?

What is the distinction between public and private nursing homes?

• Public nursing homes are contracted with the HSE and charge maximum agreed prices (HSE (Ireland’s health service))
• Private nursing homes set their own fees, but the HSE subsidy is capped

How does the Fair Deal scheme make care affordable?

• It caps your personal contribution based on your income and assets (HSE (Ireland’s health service))
• Without the scheme, nursing home costs can exceed €1,000 per week

What is the maximum agreed price?

• The HSE sets maximum agreed prices for public and some private homes (Irish Farmers’ Association PDF (farming advisory group))
• These prices are reviewed periodically

The implication: No nursing home is free, but the Fair Deal scheme ensures that even people with limited means can access long-term care. The cost you pay is far below the market rate.

Steps to apply for the Fair Deal scheme

1. Get a care needs assessment from the HSE to confirm you need long-term nursing home care (HSE (Ireland’s health service))
2. Complete the application form (Part 5 covers the nursing home loan if needed) (Irish Farmers’ Association PDF (farming advisory group))
3. Gather supporting documents: bank statements (last 6 months), property valuation, legal documents for principal residence (Irish Farmers’ Association PDF (farming advisory group))
4. Send the completed form and documents to your local Nursing Homes Support Office (HSE (Ireland’s health service))
5. Once approved, choose a registered nursing home and the HSE will pay its share

Timeline of the Nursing Home Support Scheme

The implication: The scheme has evolved steadily since its 2009 introduction, with digitisation in 2023 making applications more accessible.

What we know and what remains unclear

Confirmed facts

• Applicant pays 80% of income and 7.5% of assets per year (HSE (Ireland’s health service))
• Asset contribution capped at 3 years (HSE (Ireland’s health service))
• State pays the remainder (HSE (Ireland’s health service))
• Principal residence included for first 3 years (HSE (Ireland’s health service))

What’s unclear

• Exact average length of stay in nursing homes
• Future changes to asset cap or income calculation
• Impact of inflation on maximum agreed prices

“The Fair Deal scheme ensures that the cost of nursing home care is shared fairly between the individual and the State, based on ability to pay.”

HSE (Ireland’s health service)

“Under the Nursing Home Support Scheme, the person pays a contribution towards the cost of care and the HSE pays the balance.”

Citizens Information Ireland (official public information service)

For Irish families navigating long-term care decisions, the Fair Deal scheme offers a structured path. The upfront cost — 80% of income plus 7.5% of assets — is significant, but the three-year limit on asset contributions provides a clear ceiling. For homeowners, the choice is straightforward: sell or contribute for three years, then keep the rest. For those with fewer assets, the State steps in almost entirely. The scheme is not free, but it is fair.

Frequently asked questions