Patrick Nulty (Dublin West, Independent)
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1150. To ask the Minister for Health if he will review as a matter of urgency recent changes to the rules for medical card eligibility, namely the exclusion of home improvement loan payments and travel-to-work expenses; if his attention has been drawn to the difficulties this is causing persons in serious need of a medical card; and if he will make a statement on the matter. [35528/13]

Alex White (Dublin South, Labour)
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Changes were made earlier this year to the medical card means test and to the income thresholds for over 70’s medical cards. These changes were made on foot of Budget 2013 which identified a wide range of savings that were required across the health services. The General Medical Service (GMS) Scheme was one of a number of areas identified in which savings were required.

A number of measures are being taken to reduce the cost of the GMS, which costs about €2 billion per year. At the end of 2012, there were about 1,986,000 qualifying people under the GMS. Medical cards make up the majority of this number, amounting to about 93% of the total. As part of Budget 2013, the Government has made provision for an additional 200,000 persons to be covered by the GMS. Nonetheless, it is important that we prioritise the use of scarce financial resources in the current budgetary position.

Among the Budget 2013 savings measures announced was a reduction in the income limits for over-70s Medical Cards. It should be noted that the overwhelming majority of medical cardholders aged over 70 years are unaffected by that change. For the wealthiest 5 per cent that are affected, those cardholders under the old income limits will continue to be provided with a free GP service. The Health (Alteration of Criteria for Eligibility) Act 2013 was enacted on the 28th March 2013 to give effect to the revised eligibility arrangements.

At that time also, it was also announced that the rules on a person's expenses that are taken into account in calculating their net income for medical card purposes would be tightened. The changes introduced by the Health Service Executive mean that payments on a home improvement loan and a €50 per week allowance for a car are excluded from the standard means test assessment. These changes took effect from April onwards.

For clarity, the exclusion from travel to work costs relates to removing the weekly amount of €50 allowed to cover standing charges, such as depreciation or other running costs, used when considering travel to work costs as an outgoing where public transport is not available or suitable and a car is required. This means that the HSE will continue to consider the standard mileage costs or public transport costs when assessing eligibility.

There are a broad range of allowable expenses under the means test assessment for medical cards that have not been affected by these changes and the need to reduce the income limits for medical cards has been avoided, by these measures.