3155. Deputy Paula Butterly asked the Minister for Health if she will consider introducing automatic entitlement to a free medical card for all persons aged over 75 years-of-age, and if she will make a statement on the matter. [60116/26]

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/.

However, 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/.

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.