Tuesday, 11 February 2014
Medical Card Eligibility
This matter relates to the medical card eligibility for individuals aged between 18 and 26 years who, due to changes made, will have their social welfare entitlement reduced to as low as €100 per week if they are not undergoing a course of study. One would presume anyone in receipt of a social welfare payment of €100 a week would receive a medical card but this is not the case. These people fall between two stools.
The national assessment guidelines on medical card eligibility state a person aged between 16 and 25 may have entitlement to a medical card or a GP visit card if they meet a number of criteria, including being a dependent of a person with a medical card or a GP visit card; being financially independent, which in this case means they earn or are in receipt of a social welfare payment in excess of €164; or if they face extenuating circumstances such as financial hardship. It is very difficult to prove such hardship given the new manner in which medical cards are assessed.
There is a loophole here as one should not have to prove financial hardship or undue hardship just because one earns less than €164. A 27 year old person who receives a social welfare payment of €188, whether living at home or not, will receive a medical card, but just because one is 24 not only is one's social welfare payment reduced to €100 per week but because one is in receipt of less than €164 per week one will not receive a medical card either. It is very unfair. For those aged between 18 and 26 the national assessment guidelines for medical card eligibility should be changed because it is not fair or right they must comply with a raft of eligibility criteria.
I know a number of individuals in my county aged between 18 and 26 years who are not living with their parents, are in receipt of €100 per week and struggling to survive but who are not entitled to a medical card. That seems daft in the extreme and throws into question the entire medical card eligibility criteria if such individuals are not deemed eligible because they are in receipt of too little from the Department of Social Protection. That is the only reason they are being refused a medical card. It does not make any sense to me and I know it is an issue that many community welfare officers are dealing with in various parts of the country. A change must be made quickly because people are finding themselves in very difficult circumstances.
I thank the Senator for raising this issue. People aged 16 to 25 years, including students, who are financially independent of their parents may be entitled to a medical card if they pass the means test. If they are financially dependent on their parents, they are normally only entitled to a medical card if their parents have one. They may be entitled to a medical card or a GP visit card if obtaining GP, medical or surgical services would be the cause of "undue hardship" or "unduly burdensome" on themselves, if financially independent, or the person on whom they are dependent. Financial independence, as it relates to persons aged between 16 and 25 years, is the standard rate of income set out in the HSE's medical card or GP visit card national assessment guidelines for a single person living with family, that is, €164. Financial independence may be achieved through student loans, education grants, employment, self-employment, part-time employment, savings or social welfare payments. Rent supplement payments are not included in establishing financial independence. Historically, when there was a single rate of social welfare allowance in the Department of Social Protection, the HSE used this rate to establish financial independence. However, under budget 2014, with the age-related rates of jobseeker's allowance set by the Department of Social Protection, the HSE's test to establish financial independence is no longer linked with social welfare allowance rates.
To reiterate, financial independence is defined as "in receipt of income equivalent to or greater than the current income guideline for a single person living with family", that is, €164 per week. The current national assessment guidelines state an applicant whose weekly income is derived solely from social welfare allowances, benefits or Health Service Executive allowances will be granted a medical card if this social welfare income is in excess of the medical card income qualifying limit that applies to the application. Social welfare payments being made at a rate less than the maximum weekly rate may be indicative of other income or means. This provision cannot be relied on by persons aged 16 to 25 years receiving only social welfare income less than €164 per week as entitling them to a medical card. There are no proposals to change the income thresholds for standard means-tested medical card eligibility.
That is the normal Civil Service response. This is discrimination against 18 to 25 year olds and deeply unfair. I ask the Minister of State to examine the issue again. I do not expect him to provide a solution tonight, but I had expected a response which suggested 18 to 25 year olds were playing a meaningful role in society and that their eligibility for a medical card should not be scuppered just because another Department had cut their weekly social welfare income. This is essentially one Department working against another. Someone needs to sit down and work this out. Can a meeting be scheduled between the Department of Social Protection and the Department of Health to come to some arrangement to assist the people concerned? The fact that they are earning too little should not make them ineligible for a medical card. It makes absolutely no sense. If such individuals get sick, how will they be able to afford to go to a doctor? They are being left high and dry. I am not making a political point because this is beyond politics. I ask the Minister of State to examine this issue again because it is simply unfair.
I do not have anything to add to the response I gave other than to say any issue which arises in the operation of the GMS is and ought to be kept under review. If there is a specific issue in respect of a particular cohort, I am happy to look carefully at it. However, I do not want the Senator to think there is any intention to make any change in what we are doing. That said, I will certainly consider carefully what he has said.