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Medical Card Eligibility

Dáil Éireann Debate, Thursday - 27 March 2014

Thursday, 27 March 2014

Questions (205)

Michael Healy-Rae

Question:

205. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence (details supplied) regarding medical cards for persons with Down's syndrome; and if he will make a statement on the matter. [14563/14]

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Written answers

Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family can qualify for a medical card. The HSE can only award medical cards in accordance with the Health Act and, therefore, it must assess applicants on the overall financial situation of the applicant and his or her spouse or partner. The HSE gives effect to this legislation through its Medical Card National Assessment Guidelines.

The HSE is obliged to operate within the legal parameters as set out in the Health Act, while also responding to the variety of circumstances and complexities faced by individuals who apply for a medical card.

Under the legislation, there is no entitlement to a medical card based on having a particular disease or illness (nor has there been previously). However, if an applicant’s means are above the financial thresholds as set out in the national guidelines, the HSE routinely examines for indications of medical or social circumstances which might result in undue financial hardship in arranging medical services and, exercising discretion, may grant eligibility for a medical card on this basis. Where persons submit an application, as a new applicant or a renewal/review, without additional medical documentation and are refused, they will receive a letter giving a calculation of the guideline thresholds and where these have been exceeded. Also, at this stage, they are informed of the option to furnish further medical documentation, to demonstrate medical expenditure related to an illness or disease, in support of their application.

Where discretion is exercised with regard to an applicant with an illness or disease, it is the medical costs of that condition on a person's financial situation that is relevant to the assessment for a medical card. In accordance with the legislation, it is not possible to award a medical card by virtue of an illness or a disease or the severity thereof.

Down’s Syndrome is covered under the Long Term Illness Scheme for which entitlement applies, irrespective of means. Where persons with Down’s Syndrome are not eligible for a medical card following an assessment of their means, the HSE can provide their full requirements in respect of prescribed medicines and appliances free of charge through this statutory entitlement. Public dental, ophthalmic and aural treatment and appliances are also available free of charge to children and in respect of any difficulties identified at child health or school health examinations.

Question No. 206 answered with Question No. 198.
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