Written answer
Medical Cards
Medical card eligibility remains primarily means-tested, so other State payments such as artists’ bursaries may affect entitlement. The Minister highlighted existing allowances and discretionary provisions for people with disabilities or significant medical costs, and said broader eligibility changes remain under review.
3358. Deputy Shónagh Ní Raghallaigh asked the Minister for Health if she will consider changing eligibility criteria for medical card holders so that disabled people do not lose their access once they receive other State benefits such as an artists' bursary; and if she will make a statement on the matter. [56007/26]
Comment on this
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 per week and still qualify for a card. It is specific to the individual’s own financial circumstances.
People under 70 are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after deduction of tax, PRSI and 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/. People aged 70 or older are assessed under medical card income thresholds which are based on gross income. However, those aged over 70 can also be assessed under the general means tested scheme where there are particularly high medical costs. Details are available at: www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/over-70s/.
The issue of granting medical cards on the basis of illness or a disability was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
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 are issued to patients that are terminally ill, or are seriously ill, and in urgent need of medical care that they cannot afford. Further information regarding emergency medical cards can be found at: www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/emergency-medical-cards/.
It should be noted that in December 2018, in determining medical card eligibility, the amount of earnings disregarded for people in receipt of Disability Allowance was increased from €120 to €427 per week and applies to the assessment process for single people and to family assessments. This significant policy change gave effect to an important recommendation of the Make Work Pay for People with Disabilities report. This substantial increase in allowable earnings acknowledges that a Medical Card is a particularly significant support and ensures that people with disabilities can continue to be supported to access care when needed.
Furthermore, people who have been on a disability payment for at least a year can retain a Medical Card for a further three years on return to work, provided they were unemployed and in receipt of the full rate of payment for a period of at least 12 months prior to commencing employment.
In addition, where a person's sole household income is derived from a social protection payment, he/she will be awarded a medical card.
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 any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.