Dáil Éireann Debate, Tuesday - 16 December 2025
1059. Deputy Ken O'Flynn asked the Minister for Health if her Department has assessed whether the continued rise in GP Visit Cards issued automatically to applicants aged 70 years and over indicates unmet need for full medical card coverage within this population; and the actions taken in response at policy level. [72243/25]
Amharc ar fhreagraMedical 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. Detailed guidelines are available at: www2.hse.ie/services/schemes-allowances/medical-cards/applying/assessment/
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.
Medical card holders are eligible for a range of services including general practitioner services from a participating family doctor (GP), approved prescribed drugs and medicines, public in-patient services in public hospitals, public hospital out-patient services, dental, ophthalmic and aural services. Apart from prescribed drugs and medicines, which are subject to a prescription charge, public health services are provided free of charge to medical card holders.
Information provided by the HSE indicates that there have been increases over recent years in the number of medical cards held by persons 70 years old and over, as outlined in the table below.
|
Year |
Number of Medical Cards held by 70-year-olds and over |
|
1 January 2020 |
359,427 |
|
1 January 2021 |
369,216 |
|
1 January 2022 |
375,937 |
|
1 January 2023 |
383,933 |
|
1 January 2024 |
391,239 |
|
1 January 2025 |
396,939 |
Separately, GP visit card holders are eligible for free visits to a participating general practitioner, removing cost as a potential barrier to GP access for many people. Since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card, which has contributed positively towards an increase in the overall numbers of GP visit card holders for this cohort.
Furthermore, under the 2023 GP GMS Agreement, GP visit card eligibility was expanded in 2023 to all children under 8 years of age, and to all those who earn up to the median household income, which has resulted in an increase in the qualifying weekly financial thresholds for a GP visit card. Over 400,000 additional persons, who otherwise would have attended their GP on a private basis, are expected to become eligible for free GP care under this expansion.
It is important to acknowledge that the administration of the 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:
• 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.
• 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.
