Duncan Smith (Dublin Fingal, Labour)
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514. To ask the Minister for Health the estimated cost of providing in 2023 medical cards to all those diagnosed with cancer; and if he will make a statement on the matter. [38336/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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Under the Health Act 1970, eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure.

The issue of granting medical or GP visit cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.

However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.

Furthermore, the HSE also has a system in place for the efficient provision of medical cards in response to emergency situations i.e., in circumstances where persons are in need of urgent ongoing medical care or are receiving end of life care. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional. Additionally, patients who have been certified by their treating Consultant as having a prognosis of 24 months or less are also now eligible for a medical card without a means assessment.

Finally, it should be noted that since 2015 medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer, for a period of five years.

With regard to the estimated cost of providing a medical card in the manner sought, this information is not readily available and it is, therefore, not possible to provide an estimate of the cost of the proposal.

Duncan Smith (Dublin Fingal, Labour)
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515. To ask the Minister for Health the estimated cost of increasing medical card income limits by 5%, 10% or 20%; the projected additional number of cards that would be issued in each case; and if he will make a statement on the matter. [38337/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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Eligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.

Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account, i.e. mortgage payments, which help to increase the amount a person can earn and still qualify for a medical card.

Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. It should be noted that in November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1,050 for a couple. This increase ensures that a greater proportion of those aged 70 and over now qualify for a medical card.

With regard to the estimated cost of the deputy's proposals, the data required to model these are not readily available and it is therefore not possible to provide an estimate of the associated cost or number of cards.

However, I wish to assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, including the current medical card income thresholds under review and any changes are considered in the context of Government policy, the annual budgetary estimates process and other issues which may be relevant.