Medical Card Eligibility

Dáil Éireann Debate, Tuesday - 30 April 2013

Tuesday, 30 April 2013

Questions (525)

Gerry Adams

Question:

525. Deputy Gerry Adams asked the Minister for Health if he will outline the criteria which determine exceptional needs; what constitutes exceptional medical needs, with regard to provision of medical card services; if he will clarify if exceptional medical needs are considered when reviewing an application which has been deemed ineligible on the basis of national income guidelines; and if he will make a statement on the matter. [19808/13]

Written answers

Minister of State at the Department of Health

Under the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means. There are currently two categories of eligibility for all persons ordinarily resident in Ireland i.e. full eligibility (medical card) and limited eligibility (all others). Full eligibility is determined mainly by reference to income limits and is granted to persons who, in the opinion of the Health Service Executive, are unable to provide general practitioner, medical and surgical services to themselves and their dependents without undue hardship. There is a provision for discretion to grant a card in cases of "undue hardship" where the income guidelines are exceeded. The HSE set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances.

The Primary Care Reimbursement Service of the Health Service Executive has confirmed that all medical card applications are firstly considered on income grounds. Where an applicant is over the income threshold applicable for a medical card and where the applicant has included details of medical circumstances along with supporting documentation such as a GP or consultant's letter, the application is then forwarded to the Medical Officer for discretionary consideration. Every application is reviewed on its own merits and the Medical Officer provides recommendations based on the nature of the medical circumstances of the applicant, considered within the context of the applicant's household income.