Barry Andrews (Dún Laoghaire, Fianna Fail)

I will take this adjournment matter on behalf of the Minister for Health and Children, Deputy Mary Harney.

Under the Health Act 2008, automatic entitlement to a medical card for persons aged 70 or over ceased on 31 December 2008 and with effect from 1 January 2009 the income thresholds for entitlement to a medical card for those aged 70 or over is €700 gross per week for a single person and €1,400 gross per week for a couple. Where a person aged 70 or over does not qualify for a medical card by virtue of his or her gross income being over the specified thresholds, he or she may apply to the HSE for a medical card or GP visit card under the existing net income thresholds, which allow for medical, nursing and other relevant expenses to be taken into account.

Notwithstanding that, the HSE may issue a medical card on a discretionary basis, if the applicant would otherwise be caused undue hardship in providing general medical and surgical services for himself or herself. Following enactment of the Health Act 2008, the HSE wrote to all medical card holders aged 70 years and over in January 2009. Persons who were in receipt of a medical card without a means test, where they were granted a card on age grounds when they reached the age of 70, were requested, if they were over the income limits set out in the Act, to make a declaration to the HSE on or before 2 March 2009.

Where persons received a medical card after undergoing a means assessment, the HSE wrote to them to advise them that they would retain their card as long as their circumstances did not change. They were not required to take any further action. It must be emphasised that in the normal course of events when the medical card of a person in any age category reaches its expiry date and comes up for review, the HSE will carry out a review to confirm their ongoing eligibility status. The review for persons aged 70 and over will not take the form of a full application but will be a simple review of gross income to ensure continued eligibility and accuracy of information.

To date, 19,954 medical cards for persons aged 70 and over have been returned or removed from the medical card register and 10,690 of these cards were returned to the HSE by persons aged 70 or over whose weekly income was in excess of the specified thresholds. It is important to note that the vast majority of people in the age group, in excess of 343,000, retained their medical card. In addition to the returned medical cards, a further 9,264 cards were removed from the medical card register as part of a data quality exercise, where for example, the HSE had been advised that the card holder is deceased or the card holder was not known at the address. I am satisfied that reviewing of medical card eligibility on expiry or change of circumstances is a necessary process to allow the HSE to maintain accurate database information and the best use of public resources.

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