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 other than for persons aged 70 years and over, who are automatically eligible for a medical card. 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 are drawn up to assist in the determination of a person's eligibility and these 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 or other circumstances would justify this. It is open to all persons to apply to the chief executive officer of the appropriate health board if they are unable to provide health services for themselves or their dependants without hardship. I understand from my Department that, for the purposes of determining eligibility, the income of a cohabiting couple is treated in the same way as the income of a married couple by health boards.