In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure. The HSE's Expert Group on Medical Need and Medical Card Eligibility also examined in 2014 the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility.
In responding to patients needs, the HSE has implemented revised processes to provide a more compassionate and more efficient process in the assessment of medical card applications. Such measures include the development of a Burden of Illness questionnaire which is used in selective circumstances where the assessing doctor in the HSE's national medical card unit requires a more comprehensive assessment of an applicant's medical and social circumstances and any resulting undue financial hardship.
The HSE is also required to undertake periodic reviews of eligibility in order to ensure that a person continues to meet the qualifying criteria required to continue holding eligibility. Every effort is made by the HSE, within the framework of the legislation, to provide a medical card application system that is responsive and sensitive to people’s needs, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. If the HSE is made aware that a person has a particular requirement, whether at application or review stage, assistance will be afforded to help that person complete the application. This assistance can be availed of through a person's local health office or by calling LoCall 1890 252 919.