Seymour Crawford (Cavan-Monaghan, Fine Gael)
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Question 106: To ask the Tánaiste and Minister for Health and Children the criteria which have to be met by an English citizen who has worked in the UK for 31 years, is married to an Irish citizen who worked in the UK for 11 years, is now living here but has been refused a medical card due to the fact that they are not receiving an EU pension; if such a person is covered under agreements with other EU countries to have the right of a medical card system; and if she will make a statement on the matter. [13775/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Regulation (EC) 1408/71 deals with the co-ordination of social security schemes, including health care, for those moving within the European Union. Under its provisions, persons who are affiliated with the health care system of member state A and who are residing in member state B can receive health care in member state B's public system on behalf of and at the cost of member state A, as if they were affiliated with its health care system. Furthermore, persons who are affiliated with the health care system of member state A and are on a temporary stay in member state B can receive health care in member state B's public system that becomes necessary during their stay, taking into account the nature of the care and the expected length of stay.

Individuals covered by this regulation residing or staying in Ireland receive a medical card, or are treated as though they have one in the case of visitors, in accordance with Annex VI of the regulation where the text relates to Ireland. This states that such persons, when residing or staying in Ireland, "are entitled free of charge to all medical treatment provided for by Irish legislation where the cost of this treatment is payable by the institution of a Member State other than Ireland."

Persons covered by the regulations include social security pensioners and their dependants residing in a country other than the country of affiliation, the country paying the pension, who are not also social security pensioners of the country of residence or employed in the country of residence. A social security pensioner of another member state residing in Ireland would, therefore, be entitled to receive a medical card if he or she is not also employed in Ireland or an Irish social security pensioner in general. The dependants residing in Ireland of such a person would also be entitled to a medical card.

Others who receive medical cards under this regulation include those employed in another member state but residing in Ireland and their dependants as well as the dependants residing in Ireland of a person employed in and residing in another member state. Temporary visitors in possession of the appropriate documentation, European health insurance card or equivalent, who become ill or injured while staying in Ireland may receive necessary health care, as described above, free of charge as though they have a medical card.

Irish citizenship is not a factor in determining eligibility for health services or for a medical card under this regulation. Eligibility for health services in Ireland under national legislation is primarily based on residency and means. The determination of eligibility for a medical card is the responsibility of the Health Service Executive. Other than for persons aged 70 years and over who are automatically entitled to a medical card, medical cards are issued to persons who, in the opinion of the HSE, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.

It should be noted that the income guidelines are not statutorily binding and even though a person's income exceeds the guidelines, a medical card may still be awarded if the HSE considers that his or her medical needs or other circumstances would justify this. It is open to all persons to apply to the HSE for health services if they are unable to provide these services for themselves or their dependants without hardship.