Dáil Éireann Debate, Thursday - 19 February 2004
179 Mr. Ring asked the Minister for Health and Children if his Department issued directives to persons on social welfare benefits with a medical card, if they go over the guidelines on their social welfare payments and if they retain their medical card. [5411/04]
View answerEntitlement to health services here is primarily based on residency and means. Under the Health Act 1970, determination of eligibility for medical cards is the responsibility of the CEO of the appropriate health board. Persons aged 70 years and over are automatically entitled to a medical card. In other cases medical cards are issued to persons who, in the opinion of the CEO, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.
Income guidelines are drawn up each year by the CEO of the health board or authority to assist in the determination of a person's eligibility for a medical card. Guidelines are revised annually in line with the consumer price index. They are not statutorily binding and even though a person's income exceeds the guidelines, a medical card may still be awarded if the CEO considers that his or her medical needs or other circumstances would justify this. It is open to all persons to apply to the CEO of the appropriate health board for health services if they are unable to provide them for themselves or their dependants without hardship.
Health board CEOs have discretion to issue medical cards. A range of income sources are excluded by the health boards when assessing medical card eligibility. Many allowances such as carers' allowance, child benefit, domiciliary care allowance, family income supplement and foster care allowance are all disregarded when determining a person's eligibility. Given these factors and the discretionary powers of CEOs, having an income that exceeds the guidelines does not mean that a person will not be eligible for a medical card. A medical card may still be awarded if a CEO considers that a person's medical needs or other circumstances would justify this.
I am conscious that increases in social welfare rates in recent years mean that rates may exceed the income guidelines for a medical card. As a result my Department has written to the chairman of the CEOs' group on a number of occasions. The most recent contact was made on 5 November 2003. He was asked to advise the CEOs of my concern that medical card holders should not be disadvantaged by virtue of increases in social welfare payments announced in the budget. They were asked to ensure that increases in social welfare payments do not lead to medical card holders losing their medical cards by reference to the income guidelines. They were also asked to make every effort to ensure that both medical card holders and applicants are made aware that increases in social welfare payments will not disadvantage them when applying to hold or retain a medical card.
