Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. Under the legislation, determination of an individual’s eligibility for a medical card is the responsibility of the HSE. The Act provides that persons who are unable, without undue hardship, having regard to their overall financial situation, to arrange GP services for themselves and family qualify for a medical card. The HSE awards medical cards in accordance with the Act. The HSE gives effect to this legislation through its Medical Card National Assessment Guidelines.
Once an application for a medical card incorporates certification from a medical consultant or a general practitioner that the applicant has a medical condition, which is categorised as terminal, and the applicant is nearing the end stage of life, the applicant will be granted eligibility to a medical card, without being subjected to a means assessment.
Medical cards issued, in such circumstances, will have a default eligibility period of 6 months, from the month of issue. Mindful that no definitive prognosis can be provided on the life expectancy of a terminally ill person, the HSE takes a sensitive approach on the review of medical card eligibility, beyond the initial 6 months period. A Medical Card Review notification is not issued and eligibility is extended to take account of the cardholder’s on-going circumstances.
With the exception of terminally ill patients in palliative care, the HSE issues all emergency cards on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and that the applicant will follow up with a full application within a number of weeks of receiving the emergency card. As a result, emergency medical cards are issued to a named individual, with a limited eligibility period of six months and the HSE reserves the right to review eligibility at any point in time to confirm that a person continues to meet the qualifying criteria required to continue holding eligibility.