Dáil Éireann Debate, Thursday - 19 February 2026
646. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives annual or quarterly statistical reports from the Health Service Executive on discretionary medical card approvals and refusals granted under the General Medical Services scheme in respect of persons aged over 70; and if she will make a statement on the matter. [13798/26]
View answer647. Deputy Ken O'Flynn asked the Minister for Health whether the data provided to her Department by the Health Service Executive on discretionary medical card decisions is disaggregated by age cohort, geographic region, and outcome; and if she will outline the categories of data routinely received. [13799/26]
View answer659. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives, holds, or reviews aggregated data from the Health Service Executive or the Primary Care Reimbursement Service on the exercise of discretion in medical card eligibility decisions following a means assessment; the total number of applications in which discretion was considered in each of the years 2020 to 2025; the number granted on a discretionary basis; the number refused following discretionary consideration; whether such data is disaggregated by age cohort including persons aged over 70; whether the Department analyses trends or regional variation in discretionary decision-making; and the policy, audit, or governance mechanisms in place to ensure national consistency in the exercise of discretion under the general medical services scheme. [13884/26]
View answer660. Deputy Ken O'Flynn asked the Minister for Health whether any formal reporting framework exists between the Health Service Executive and her Department in respect of discretionary medical card decisions; the frequency of any such reporting; whether performance indicators, audit reviews, or internal compliance checks are conducted in relation to discretionary refusals; and if she will outline the Department’s role in supervising the exercise of discretion under the general medical services scheme. [13885/26]
View answerI propose to take Questions Nos. 646, 647, 659 and 660 together.
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. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner and other medical services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure.
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. 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.
Regarding the arrangements in place within the Department to monitor medical card trends, officials from my Department engage in monthly Performance Report meetings with the HSE Primary Care Reimbursement Service. 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 changes are considered in the context of Government policy and other issues which may be relevant.
Regarding the specific data requested on the discretionary medical card assessment process, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
