Determination of eligibility for a medical card is the responsibility of the Health Service Executive and is based on a national assessment process for medical cards, details of which are available on the HSE's website (www.hse.ie). If a person has been refused a medical card they can lodge an appeal within 21 days. Details of the appeals process are forward to the applicant with their refusal letter. As this refusal of a medical card renewal is a service matter I have referred it to the Health Service Executive for direct reply to the Deputy.