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. The Act obliges the HSE to assess whether a person is unable, without due 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 cards on the basis of illness or a disability 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.

The HSE is also required to undertake periodic reviews of eligibility in order to ensure that a person continues to meet the qualifying criteria required to continue holding eligibility. It is important to note that where any medical or GP visit card holder has a review process initiated, he/she will continue to retain his or her eligibility for the duration of the review process (typically three months).

Every effort is made by the HSE, within the framework of the legislation, to provide an eligibility assessment process that is responsive and sensitive to people’s needs, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services and to that end, the HSE may exercise discretion and grant a medical card where an applicant exceeds his or her income threshold.

Since December 2018, the medical card earnings disregard for people in receipt of Disability Allowance was increased from €120 to €427 per week and applies to the assessment process for single people and to family assessments. This significant policy change gave effect to an important recommendation of the Make Work Pay for People with Disabilities report. This substantial increase in allowable earnings acknowledges that a Medical Card is a particularly significant support and ensures that people with disabilities can continue to be supported to access care when needed.

Furthermore, people who have been on a disability payment for at least a year can retain a Medical Card for a further three years on return to work, provided they were in receipt of the payment for a period of at least 12 months prior to commencing employment.