John McGuinness (Carlow-Kilkenny, Fianna Fail)
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192. To ask the Minister for Health if the HSE will respond to the extensive correspondence from a person (details supplied); if an unreserved apology and refund of fees will be issued by the HSE to the person; and if she will make a statement on the matter. [21398/25]

Mary Butler (Waterford, Fianna Fail)
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The Department has contacted the Deputy in relation to this PQ to seek further clarity in relation to this matter and will progress this request once this additional information has been received.

James O'Connor (Cork East, Fianna Fail)
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193. To ask the Minister for Health if she will review correspondence (details supplied); and if she will make a statement on the matter. [21408/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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Medical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.

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. Detailed guidelines are available at: .

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.

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.

Separately, under the Long-Term Illness Scheme, patients (including those diagnosed with multiple sclerosis) receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. In 2023, GP visit card means-tested eligibility was extended to those who earn up to the median household income, and public in-patient charges in public hospitals were abolished.

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