Entitlement to health services in Ireland is primarily based on means. 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 to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship. 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 the person's medical needs or other circumstances would justify this.
Persons aged 16 to 25, including students, who are dependants of a person who is not a medical card holder, are not normally entitled to a medical card. An exception to this is where they have an entitlement under EU regulations or where they are in receipt of a disability allowance. Students who are financially independent are entitled to apply for a medical card in their own right and are assessed on the same income criteria as all other applicants. The decision on whether a person is regarded as a dependant or as being financially independent is made by the chief executive officer of the health board on the basis of the circumstances in each individual case.
