Thomas Byrne (Meath East, Fianna Fail)
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Question 255: To ask the Minister for Health and Children the reason for the withdrawal of a medical card in respect of a person (details supplied) in County Meath. [36753/09]

Mary Harney (Dublin Mid West, Independent)
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As this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.

Noel Ahern (Dublin North West, Fianna Fail)
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Question 256: To ask the Minister for Health and Children the position regarding the operations of the over 70 years medical card; if it is being operated as announced after the 2008 debate; if discretion will be used for applicants who are just over the €700 limit with high medical expenses; if current applicants on gross income of between €720 and €730 are being refused as a matter of rule; the normal income guideline figure for persons over 70 years of age; if the higher figure built up in recent years for over 70 years was maintained; the reason it was dropped; and if reasonable medical costs will be allowed for in cases of persons over €700. [36764/09]

Mary Harney (Dublin Mid West, Independent)
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There are three routes by which a person aged 70 or over may qualify for a medical card. Firstly, under the Health Act 2008, a single person will qualify if his/her gross income is €700 per week or less. The figure for a couple is €1,400 per week or less. The 2008 Act does not allow any discretion to the Health Service Executive (HSE) to grant medical cards to persons who are in excess of these gross income thresholds.

Secondly, a person who does not qualify for a medical card by virtue of the gross income limits in the 2008 Act will qualify if his/her net income is €201.50 or less. In the case of a couple, their net income must be €298 or less. Medical, nursing and other relevant expenses are taken into account when using the net income thresholds to assess a person's eligibility. Thirdly, if a person does not qualify under either the gross or net income thresholds, the HSE may issue a medical card on a discretionary basis, if the applicant would otherwise be caused undue hardship in providing general medical and surgical services for himself/herself and any dependants. Special net income thresholds were used prior to the enactment of the Health Act 2008 to assess eligibility where a person aged under 70 years was married to a medical card holder aged 70 years or over. These special thresholds have been discontinued as couples now qualify for a medical card under the 2008 Act if their joint weekly gross income does not exceed the significantly higher figure of €1,400. If they do not qualify under this assessment, they may still qualify for a card on a discretionary basis as outlined above.