David Cullinane (Waterford, Sinn Fein)
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195. To ask the Minister for Health if she intends to index medical card income thresholds to annual social welfare increases to prevent the loss of medical card access for low-income individuals with disabilities. [21418/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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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 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: .

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. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card. 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.

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.

Furthermore, people who are unemployed and have been on a full rate of 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. Where a person's sole income is derived from a social protection payment, even where this is more than the current means threshold, he/she will be awarded a medical card.

I can assure the Deputy that, in order 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.