Written answers
Tuesday, 5 November 2024
Department of Health
Medical Cards
Francis Noel Duffy (Dublin South West, Green Party)
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1006. To ask the Minister for Health if his Department has sought to resolve the issue regarding the loss of medical cards due to the pension increase in Budget 2025; and if he will make a statement on the matter. [43965/24]
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. 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. Detailed guidelines are available at: .
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. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high costs, e.g., medication, nursing home fees. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
As of 1st October 2024, 1,570,945 people have medical cards and 702,467 people have GP visit cards. This means that more than 42% of the population have access to free GP care.
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.
- In addition, as per the HSE's medical card guidelines, should a person's sole income be derived from a social welfare payment, a medical card will be granted even when the social welfare payment is above the income thresholds.
- I can assure the Deputy that my Department keeps medical card issues under review in order to ensure the medical card system is responsive and sensitive to people's needs. Over the course of 2024 and 2025, we will review the existing eligibility framework to clearly assess what is working well and to inform policy proposals to enhance eligibility and access to services based on robust evidence. This is an important step towards delivering on universal healthcare in Ireland.
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