Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines.
The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. There is currently no review underway into the processing of discretionary medical cards.
However regarding emergency medical cards, I announced as part of Budget 2020, that the HSE would undertake a review and extend arrangements regarding the provision of emergency medical cards in cases of terminal illness. A Clinical Advisory Group, established by the HSE, will carry out the review and provide a report on completion.