Under the Health (Alteration of Criteria for Eligibility) (No. 2) Act 2013, when a person attains the age of 70, the medical card income limits are €500 gross income per week for a single person and €900 gross income per week for a couple. Persons aged 70 or older who are assessed as ineligible under the gross income thresholds may also have their eligibility assessed under the general means-tested medical card scheme if they so wish, for example in the event that they face particularly high expenses, e.g. nursing home or medication costs. This scheme is open to all persons, irrespective of their age and assessment is based on net income and assessable outgoing expenses. The general scheme, although having lower income thresholds, provides for income disregards and relevant outgoings to be taken into account in the assessment process.
Under the medical card legislation, having a particular illness in itself, does not establish eligibility for a medical card and therefore, the medical conditions of applicants for this scheme are not monitored on that basis. However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines.
In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her income threshold, where he or she faces difficult circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses. In addition, from August 2015, all persons aged 70 or older qualify for a GP Visit Card, regardless of income.
There are no proposals at present to amend the legislation for the granting of eligibility for medical cards for persons aged 70 and over. However, it should be noted that the gross income limits are reviewed annually and considered in the context of the budget.
With regard to services for people with Parkinson's disease, the HSE funds a range of community services and supports to enable each individual to achieve their full potential and maximise independence, including living as independently as possible. Services are provided in a variety of community and residential setting in partnership with service users, their families and carers and a range of statutory, non-statutory, voluntary and community groups. Services are provided either directly by the HSE or through a range of voluntary service providers.
Services are accessed through an application process through the relevant local health office or through referrals from public health nurses or other community based staff. Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria and the level of resources available.
