Medical card provision is primarily based on financial assessment. Under the legislation having a particular illness does not establish eligibility for a medical card and therefore the medical conditions of applicants are not monitored on that basis.
The HSE’s Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for a medical card. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This remains the current situation and there are no plans to amend the current income thresholds for medical cards.
Notwithstanding this fact, I do recognise the importance of having a medical card application system that is responsive and sensitive to people’s needs. In this regard 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. This includes taking full account of all the circumstances of an applicant including medical evidence of the cost of their illness and other related expenses.
With regard to persons suffering from cancer and other serious medical conditions the HSE also has a system in place for the provision of medical cards in response to emergency situations, i.e. in circumstances where persons with serious medical conditions are in need of urgent or on-going medical care that they cannot afford and also for persons in palliative care who are terminally ill. These medical cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are followed up with a full application within a number of weeks.
I would also like to note that since 1 July 2015, the HSE adopted the position that all children under 18 years of age with a diagnosis of cancer are awarded a medical card. This card is valid for a period of 5 years.