Dáil Éireann Debate, Tuesday - 24 September 2024
528. Deputy Eoin Ó Broin asked the Minister for Health if there is a mechanism through which an individual with a diagnosis of a long-term illness but who is not in possession of a medical card can be appointed to a GP in their local area; and if so, if the process will be outlined. [37857/24]
Amharc ar fhreagraGPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders.
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 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 aged 70 or older are assessed under medical card income thresholds which are based on gross income. 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. Detailed guidelines are available from the HSE website.
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 issued to patients that are terminally ill, or are seriously ill, and in urgent need of medical care that they cannot afford.
• Medical cards issued to patients who are terminally ill with a prognosis of 24 months or less do not require subsequent means assessment and are not reviewed.
Eligibility for a GP visit card for those aged between 8 and 69 years of age is also primarily based on a financial assessment. The qualifying threshold calculation takes into consideration the applicant’s particular expenses as well as their income, allowing for those who have a higher income but also experience high expenses to potentially qualify. All children under 8 years of age and persons aged 70 years and over are eligible for a GP visit card on the basis of their age.
Further information on how the HSE assesses GP visit card eligibility and information regarding persons who are automatically eligible for a GP visit card is available from the HSE website.
Where a person who holds a medical card or GP visit card, experiences difficulty in finding a GP to accept them as a patient, that person having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign a GMS patient to a GP's GMS patient list in accordance with the GMS contract.
People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with. As private practitioners, it is a matter for each individual GP to decide whether to accept additional private patients. Where a GP practice has a full list of patients and cannot take on new patients, patients should contact other GP practices in the surrounding areas. The HSE website provides a "Find a GP" facility which can assist in finding nearby GP practices.
