Under the Health Act, 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. Medical cards are issued to persons who, in the opinion of the chief executive officer are unable, without undue hardship, to provide general practitioner, medical and surgical services for themselves and their dependants.
Income guidelines have been drawn up by the chief executive officers to assist in the determination of a person's eligibility and these guidelines are revised annually in line with the consumer price index. However, the guidelines are not statutorily binding and even though a person's income exceeds the guidelines, a medical card may still be awarded if the chief executive officer considers that his or her medical needs would justify this. Medical cards may also be awarded to individual family members on this basis.
It is important to note that entitlement to a medical card is based on hardship rather than on any specification that a particular percentage of the population should have a card. The decrease in the percentage of the population with a card is a reflection of a general improvement in the economy in recent years.