I propose to take Questions Nos. 131 and 132 together.
Under the Health Act 2008, automatic entitlement to a medical card for persons aged 70 and over ended on 31st December 2008. With effect from 1st January, 2009, the income thresholds for entitlement to a medical card for those aged 70 and over are €700 (gross) per week (€36,500 per year) for a single person and €1,400 (gross) per week (€73,000 per year) for a couple.
In early January 2009, the HSE wrote to persons aged 70 and over who were medical card holders on 31st December 2008, informing them that either they will continue to hold their card or, if they consider that they are over the income thresholds, they should advise the HSE by 2nd March 2009, after which date their medical card is no longer valid.
Under the new arrangements, a much simplified system of assessment for eligibility was introduced in respect of persons aged 70 and over, based on gross income rather than net income, as applies otherwise for means-testing of eligibility for medical cards.
The simplified approach taken for persons aged 70 and over who held a medical card prior to 31st December 2008 is close to a self-assessment system. In introducing the measures, I emphasised my belief in the honesty and integrity of the vast majority of older persons in our society.
There are measures in the legislation that allow for the sharing of data between State agencies and the Health Service Executive (HSE) to allow the HSE to verify in any particular case if the person has income, as declared, under the gross income limit.
Long-standing provisions of the Health Act 1970, as amended, continue to apply. For instance, under Section 49 (1) there is a requirement for a person to notify the HSE of any change in his/her circumstances which would render him/her ineligible for services. In addition, under Section 50, when a person has obtained a service and it is later ascertained that he/she was not entitled to the service, the HSE may charge the individual for any services provided to him/her for the period for which he/she had no entitlement. Failure to notify the HSE or the use of a service one is not entitled to is an offence on summary conviction.
The Health Act 2008 provides that the HSE shall provide any necessary supports to any person aged 70 or over in the making of an application for a medical card where, by reason of any incapacity, such person requests such assistance.