Written answers

Tuesday, 15 July 2014

Department of Health

Medical Card Eligibility

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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604. To ask the Minister for Health the reason persons over 70 are means tested for a medical card on gross income while a person under 70 applying for a medical card is means tested on net income; if this constitutes discrimination under equality legislation; and if he will make a statement on the matter. [31006/14]

Photo of Joan CollinsJoan Collins (Dublin South Central, United Left)
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606. To ask the Minister for Health in view of the changes to the over 70s medical card criteria and a cap of €500 single and €900 couple gross weekly income this year, meaning that a number of pensioners are over the limit by €10, €20, €30 per week because they are in receipt of a State pension and a work pension, if he will introduce the same criteria for the general medical card scheme where gross earnings less PRSI and income tax, and allowable expenditure such as medical cards and house insurance and so on are taken into account for the over 70s medical card. [31177/14]

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 604 and 606 together.

Applications for persons aged 70 years and older can be assessed both on the basis of the standard national assessment guidelines and on the basis of the guidelines for persons aged 70 years or over.

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. There are no proposals to change this assessment process and it is not seen to constitute discrimination under equality legislation.

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 where discretion is exercised where they face undue hardship in arranging medical services as a result of medical or social circumstances.

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