Under the provisions of the Health Act 1970, medical cards are provided to persons who are, in the opinion of the Health Service Executive (HSE) unable without undue hardship to arrange GP services for themselves and their dependants. Assessment for a medical card is determined primarily by reference to the means, including the income and reasonable expenditure, of the applicant and his or her partner and dependants.
There is also provision for discretion by the HSE to grant a card in cases of "undue hardship" where the income guidelines are exceeded. Following the centralisation of medical card processing, the Minister ensured that discretionary medical cards would be based on consistent medical grounds by requesting the HSE to set up a panel to assist in the screening of applications for medical cards on a discretionary grounds. Such cases are decided by a qualified Medical Officer. Medical expenses are taken into account when assessing an application on hardship grounds.
The HSE has produced national assessment guidelines to provide a clear framework to assist in the making of reasonable, consistent and equitable decisions when assessing an applicant for the General Medical Services scheme. These guidelines are publicly available and can be downloaded from the HSE's medical card website.
If an individual is not satisfied with a decision made by the HSE concerning an entitlement to a medical card or GP visit card, a person has a right of appeal to the HSE Appeals Officer. An appeal must be lodged by the applicant within twenty-one days of the decision.