In accordance with the Health Act, 1970, as amended, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants. I will take this opportunity to remind the Deputy that, there is no, nor has there ever been, an entitlement to a medical card for a person with a particular illness or medical condition under the legislation.
Under the Act, the HSE is obliged, in deciding on an individual’s eligibility, to have regard to the person’s overall financial situation, including the means of the spouse, if any, in view of the reasonable expenditure in relation to him or herself and his or her dependants.
If an applicant’s means are above the financial thresholds, as outlined in the National Assessment Guidelines, the HSE routinely considers whether the refusal of eligibility will result in undue financial hardship for the applicant or any dependants. Eligibility may be granted, if the applicant is above the guidelines, but cannot arrange general practitioner, medical and surgical services, for themselves and their dependants, without being caused undue financial hardship. Where discretion is exercised with regard to an applicant with an illness or disease, it is the effect of reasonable expenditure related to that condition on a person's financial situation that is relevant to the assessment for a medical card.
All medical card and GP visit card holders are subject to a periodic review of eligibility to determine continuing eligibility. Under the review process, applicants are not asked if they - or a family member - still has a lifelong condition or illness. As I have outlined, the card is not awarded based on a medical condition and, in this regard, such like questions would be neither pertinent nor appropriate.
However, the HSE is obliged under the review process to ensure that full account is taken of any costs that a family may have that arise from a change in their circumstances, perhaps an exacerbation of an illness or a secondary illness. Any questions on change in circumstances refer to the resultant financial impact and do no not refer to a person still having the particular life-long condition or particular illness. The information sought is to support the determination of undue financial hardship due to the costs associated with having a medical condition or illness.