Under the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means and medical cards are not awarded to any particular group of patients on the basis of a specific medical condition. However, the HSE has discretion to grant a medical card in certain circumstances. Medical card applicants who are unsuccessful following the means assessment, but who indicate that they suffer from a medical condition, are then referred to the Medical Officer for consideration on a medical discretionary basis.
All applications for a Medical Card are assessed under the National Assessment Guidelines. In accordance with these guidelines, all Medical Card applications are first assessed on income grounds. Where an applicant is over the income threshold applicable to them to qualify for a Medical Card their application is considered on discretionary grounds. Discretionary medical circumstances are considered by the Medical Officer within the context of the applicant’s household income.
In cases where a Medical Card is required in emergency circumstances, such as for terminal illness or for a serious medical issue, an Emergency Medical Card may be issued. Such an application can be initiated through the Local Health Office whose manager has access to a dedicated fax and e-mail contact line to the PCRS. Details of this procedure have been made available to all GPs and Social Workers. Such cards will be issued within 24 hours. As before, no means test applies to an application by a terminally ill patient and all terminally ill patients will be provided with a Medical Card number for a period of six months once their medical condition is verified by a GP or a consultant.
