All applications for medical cards, except those for persons aged 70 years and over, are assessed by the local health boards on the grounds of medical need and income.
Entitlement to health services here is primarily based on means. Under the Health Act 1970, determination of eligibility for medical cards is the responsibility of the CEO of the appropriate health board. Persons aged 70 years and over are automatically entitled to a medical card. They are issued to persons who, in the opinion of a CEO, 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. They are revised annually in line with the consumer price index. The guidelines are not statutorily binding. A medical card may be awarded if a CEO considers that a person's medical needs or other circumstances justify it even though their income exceeds the guidelines.