Joe Carey (Clare, Fine Gael)
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612. To ask the Minister for Health the reason for using gross income for the calculation of medical card eligibility for the over 70s and net income for those under 70; and if he will make a statement on the matter. [5495/14]

Alex White (Dublin South, Labour)
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Automatic eligibility for a medical card for persons aged 70 years and over was difficult to justify in the then economic and fiscal climate. Under the Health Act 2008, automatic entitlement to a medical card for persons aged 70 and over ended on 31 December 2008. Under the arrangements effected by the Act, a revised system of assessment for eligibility was introduced for those 70 years of age and over, based on the significantly higher gross income limits rather than the standard net income thresholds. This advantageous arrangement for persons aged over 70 years has facilitated a much greater share of this cohort qualifying for a medical card compared to the general population as a whole.

In the main, persons in the over-70s age cohort do not have the same outlays and expenses as those under 70 years of age who are assessed on a means basis. Under the standard means tested medical card scheme, allowance may be made for rent/mortgage, travel to work and child care costs. Generally, for the over 70s, mortgages have been cleared, children have been catered for and they would not have travel to work related costs.

However, persons aged 70 or older who are assessed as ineligible under the gross income thresholds may also have their eligibility assessed under the means tested medical card scheme where they face particularly high expenses, e.g., nursing home or medication costs. As I have outlined, this assessment is based on net income and assessable outgoing expenses and the qualifying income thresholds under this scheme are lower than over -70s gross income thresholds.

Furthermore, persons aged over 70 years may still be eligible for a medical card on a discretionary basis where they face undue hardship in arranging medical services as a result of medical or social circumstances.