Alex White (Dublin South, Labour) | Oireachtas source

Under the Health Act 2008, automatic entitlement to a medical card for persons aged 70 and over ended on 31 December 2008. Under the arrangements effected by the Act, a revised system of assessment for eligibility was introduced for those 70 years of age and over, based on the significantly higher gross income limits rather than the standard net income thresholds. This advantageous arrangement for persons aged over 70 years has facilitated a much greater share of this cohort qualifying for a medical card compared with the population as a whole.

In the main, persons in the over 70 age cohort do not have the same outlays and expenses as those under 70 who are assessed on a means basis. Under the standard means tested medical card scheme, allowance may be made for rent or mortgage, travel to work and child care costs. Generally, for the over 70s, mortgages have been cleared, children have been catered for and they would not have costs for travel to work.

However, persons aged 70 or older who are assessed as ineligible under the gross income thresholds may also have their eligibility assessed under the means tested medical card scheme where they face particularly high expenses, for example, nursing home or medication costs. As I have outlined, this assessment is based on net income and assessable outgoing expenses and the qualifying income thresholds under this scheme are lower than the gross income thresholds for those over 70.

Furthermore, persons aged over 70 years may still be eligible for a medical card on a discretionary basis where they face undue hardship in arranging medical services as a result of medical or social circumstances. There are no proposals to change the assessment from a gross income basis to a net income basis for the over 70 age cohort.

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