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 70 or older are assessed under medical card income thresholds which are based on gross income. The weekly gross medical card income thresholds for people aged 70 and over are currently €550 per week for a single person and €1050 for a couple.

Persons under 70 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. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance, nursing home net costs which help to increase the amount a person can earn and still qualify for a medical card. For people under 70, the thresholds range from €184 per week for a single person living alone aged under 66, to €298 per week for married, cohabiting couple or a single parent family aged over 66 (with additional amount for each child dependant). Detailed guidelines are available at: Assessment for a medical card - HSE.ie.

Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card - in particular, to take full account of difficult circumstances in the case of applicants who may be in excess of the income guidelines. In such circumstances, the HSE may exercise discretion and grant a medical card, for example:

• Discretionary medical cards issued to patients with significant medical expenses but who do not satisfy the means test.
• Emergency medical cards are issued to patients that are terminally ill, or are seriously ill, and in urgent need of medical care that they cannot afford.
• Medical cards issued to patients who are terminally ill with a prognosis of 24 months or less do not require subsequent means assessment and are not reviewed.
• As of 1^stJanuary 2024, 1,611,187persons hold eligibility for a medical card, of which 184,624cards are provided on a discretionary basis.
• As of 1^stJanuary 2024, 630,474hold eligibility for a GP Visit Card, of which 39,244cards are provided on a discretionary basis.

Furthermore, the expansion of GP visit card eligibility to all people who earn up to the median household income has resulted in increase in the qualifying weekly financial thresholds for a GP visit card. Over 400,000 additional persons, who otherwise would have attended their GP on a private basis, are expected to become eligible for free GP care under this expansion.

To ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.