Dáil debates

Thursday, 20 June 2024

Saincheisteanna Tráthúla - Topical Issue Debate

Medical Cards

2:15 pm

Photo of Jack ChambersJack Chambers (Dublin West, Fianna Fail) | Oireachtas source

I thank the Ceann Comhairle and Deputy Browne for their kind wishes.

I also thank Deputy Browne for raising this important issue. Eligibility for a medical card is primarily based, as the Deputy knows, on a financial assessment, which is conducted by the HSE in accordance with the Health Act 1970. The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn per week and still qualify for a card. It is specific to the individual’s own financial circumstances.

As of 1 June, there were almost 1.59 million medical card holders in Ireland, and just over 667,000 GP visit card holders. Persons aged 69 and under are assessed under the general means tested medical card thresholds, which are based on an applicant’s household income after tax and the deduction of PRSI and the universal social charge. Certain expenses are also taken into account. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance and nursing home net costs. This helps to increase the amount a person can earn and still qualify for a medical card. Some social welfare payments, for example, child benefit and fuel allowance, are also exempt from medical card income assessment.

The issue of granting a medical or GP visit card based on having a particular disease, diagnosis or illness was previously examined in 2014 by the HSE expert panel on medical need and medical card eligibility. The group concluded that it was not feasible or ethically justifiable to list specific medical conditions in priority order for medical card eligibility. In following the expert group’s advice, a person’s means remains the main qualifier for a medical card. Against this background, medical cards issued are generally subject to review by the HSE in the usual way, taking account of individual and other relevant circumstances. Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness.

Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.

I assure the Deputy that in order to ensure the medical card system is responsive and sensitive to people's needs, the Minister for Health and his Department keep medical card issues under review. Any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary Estimates process and the legislative requirements arising from such a review.

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