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 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.
Eligibility reviews were temporarily suspended by the HSE Primary Care and Eligibility Reimbursement Service (PCERS) during the initial phase of the COVID-19 pandemic. Cards that were due to expire during March and August 2020 were automatically extended for up to one year and will be re-assessed on a planned basis. This temporary measure was taken in the initial phase of the Covid-19 pandemic in order to preserve necessary resources for emergency HSE Covid-19 responses. While the HSE PCERS have resumed eligibility reviews, it is important to note that where any medical or GP visit card holders has a review process initiated, he/she will continue to retain their eligibility for the duration of the review process. It is noted that every effort is made by the HSE, within the framework of the legislation, to provide an eligibility assessment process 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. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services and to that end, the HSE may exercise discretion and grant a medical card where an applicant exceeds his or her income threshold.
Furthermore, the HSE have also introduced a number of helpful operational measures since the onset of COVID-19 that have temporarily removed some of the requirements that would normally be expected for the completion of a medical card application.