Entitlement to health services in Ireland is primarily based on means. Under the Health Act, 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.
Income guidelines are drawn up to assist in the determination of a person's eligibility and these are revised annually in line with the consumer price index. The guidelines are not statutorily binding and even though a person's income exceeds the guidelines, a medical card may still be awarded if the chief executive officer considers that his or her medical needs or other circumstances would justify this. Medical cards may also be awarded to individual family members on this basis. It is open to all persons to apply to the chief executive officer of the appropriate health board for health services if they are unable to provide these services for themselves or their dependants without hardship.