Dáil Éireann Debate, Tuesday - 10 February 2026
1132. Deputy Pa Daly asked the Minister for Health the rationale for access to medical cards in Ireland remaining subject to a means test, particularly in light of the system in the United Kingdom where access to healthcare is not means tested; and if she will make a statement on the matter. [10179/26]
View answer1133. Deputy Pa Daly asked the Minister for Health whether her Department has considered the experience of Irish citizens returning from the United Kingdom who encounter differences in access to healthcare supports, including eligibility for medical cards; whether guidance or information is provided to assist such individuals in understanding the Irish system; and if she will make a statement on the matter. [10180/26]
View answerI propose to take Questions Nos. 1132 and 1133 together.
Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is primarily based on residency and means. Any person, who is accepted by the Health Service Executive (HSE) as being ordinarily resident in Ireland is entitled to either full eligibility (i.e. medical card holders) or limited eligibility (i.e. non-medical card holders) for health services. The HSE normally regard a person as "ordinarily resident" in Ireland if they satisfy the HSE that they have been living in Ireland for at least a year or that it is their intention to remain in Ireland for a minimum period of one year.
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. 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.
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.
Detailed guidance and information regarding medical card eligibility, can be found in the HSE’s Medical Card and GP Visit Card National Assessment Guidelines (www.hse.ie/eng/staff/pcrs/medical-card-and-gp-visit-card-assessment-guidelines.pdf). Furthermore, the HSE website is another source of information on the Irish Health system. Details are available at: www.hse.ie/eng/staff/pcrs/medical-card-and-gp-visit-card-assessment-guidelines.pdf.
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.
