Under the Health Act 1970, eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without undue 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. In doing this, the HSE assesses each medical card application on a qualifying financial threshold. 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.
Where a person's sole income is derived from a Social Protection payment, he/she will be awarded a medical card.
In response to the query raised by the Deputy, my Department has not issued any recent specific guidance or circulars to deciding officers and medical officers regarding the assessment of older applicants as part of the medical card assessment process.
As part of the question is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
