Dáil Éireann Debate, Wednesday - 17 December 2025
373. Deputy Michael Cahill asked the Minister for Health if she will increase the qualifying income limits for a medical card in respect of senior citizens (over 70), as these limits have not been increased in years and are totally out of line with the cost of living crisis; and if she will make a statement on the matter. [72676/25]
View answerMedical 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. 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. Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. 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 medical costs. Detailed guidelines are available at: www.hse.ie/eng/staff/pcrs/medical-card-and-gp-visit-card-assessment-guidelines.pdf
Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
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. 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.
Where a person's sole income is derived from a Social Protection payment, he/she will be awarded a medical card.
It is important to acknowledge that the administration of medical card exists within a wider eligibility framework, and that a range of other measures have also been implemented over recent years to help increase access to and the affordability of healthcare services, for example:
• since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
• under the Long-Term Illness Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
• under the Drugs Payment Scheme (DPS) no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
• In 2023, GP visit card means-tested eligibility was extended to those who earn up to the median household income.
• GP visit card eligibility was extended from all children under 6 to children under 8.
• Public in-patient charges in public hospitals have been abolished.
• Individuals may also be entitled to claim tax relief on the cost of qualifying health expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
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. There is a programme of work currently underway in my Department which is reviewing the existing eligibility framework, to clearly assess what is working well and to inform future policy proposals regarding the eligibility framework based on robust evidence. This is an important step towards delivering on universal healthcare in Ireland.
