Michael Noonan (Limerick East, Fine Gael)
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Question 174: To ask the Tánaiste and Minister for Health and Children if in accordance with an EU agreement persons in receipt of UK social welfare pensions are entitled to medical cards here if they are resident and that these cards are awarded without a means test; and if she will make a statement on the matter. [18241/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Regulation (EC) 1408/71 deals with the coordination of social security schemes, including healthcare, for those moving within the European Union. Under its provisions, persons who are affiliated to the healthcare system of Member State A and who are residing in Member State B can receive healthcare in Member State B's public system on behalf of and at the cost of Member State A, as though they were affiliated to its healthcare system. Furthermore, persons who are affiliated to the healthcare system of Member State A and on a temporary stay in Member State B can receive healthcare 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 Regulation (EC) 1408/71 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 (text relating 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 (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, therefore, residing in Ireland would in general be entitled to receive a medical card if s/he is not also employed in Ireland or an Irish social security pensioner. The dependants residing in Ireland of such a person would also be entitled to a medical card.

Others who receive medical cards under Regulation (EC) 1408/71 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 healthcare, as described above, free of charge, i.e. 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 Regulation (EC) 1408/71.

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.