Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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516. To ask the Minister for Health if he will outline for the past ten years each time the income threshold to qualify for a medical card got updated or altered; and if he will respond with details of each or any update to qualify for a medical card. [18999/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Eligibility for a medical card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card and is specific to the individual’s own financial circumstances. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.

Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account, i.e. mortgage payments, which help to increase the amount a person can earn and still qualify for a medical card.

With effect from April 2013, the gross income thresholds for people aged 70 and over were amended to €600 for a single person and to €1,200 a week for couples. From January 2014, the Health (Alteration of Criteria for Eligibility) (No. 2) Act 2013 amended gross weekly medical card income thresholds for those aged 70 or older to €500 per week for a single applicant and €900 per week for a couple. With effect from November 2020, the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 increased gross weekly medical card income thresholds for those aged 70 or older to €550 per week for a single applicant and €1,050 per week for a couple.

In circumstances where an applicant may be over the income limit for a medical card, Government approved the introduction of GP visit cards to enable eligible people make GP visits without charge. The Health (General Practitioner Service) Act 2014 introduced automatic eligibility for GP visit cards for those under 6 years of age. The Health (General Practitioner Service) Act 2015 introduced automatic eligibility for GP visit cards for those aged 70 or older. Under this legislation, access to a GP service is provided to all persons over the age of 70 on a universal basis. On 1 April 2019, GP visit card weekly income thresholds were increased by 10% as part of measures announced in Budget 2019.

I can assure the Deputy that, in order to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, including the current medical card income thresholds, under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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517. To ask the Minister for Health if he plans to update the income threshold for a medical card to align with the current cost of living. [19000/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Eligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.

Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance, nursing home net costswhich help to increase the amount a person can earn and still qualify for a medical card. Detailed guidelines are available at: Assessment for a medical card - HSE.ie.

Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. It should be noted that in November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1050 for a couple. This increase helps to ensure that a greater proportion of those aged 70 and over qualify for a medical card. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high costs, e.g., medication, nursing home fees. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.

I can assure the Deputy that, in order to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, including the current medical card income thresholds, under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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518. To ask the Minister for Health if he plans to update the qualification criteria for a medical card to consider long-term illnesses that have a cost burden on a household; and if he will make the qualification for a medical card to be more flexible to take in cost factors that are not on the current list. [19001/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Medical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.

The issue of granting medical or GP visit cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.

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. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.

I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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519. To ask the Minister for Health if he plans to expand the medical card to all cancer patients under treatment. [19002/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Medical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.

The issue of granting medical or GP visit cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.

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. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.

The HSE also has a compassionate system in place for the provision of medical cards where persons are in need of urgent ongoing medical care or when a patient is receiving end of life treatment – that is when patients’ unfortunately have a prognosis of less than 12 months. In addition, since March 2021, persons who have been certified by their treating Consultant as having a prognosis of 24 months or less are now also awarded a medical card on an administrative basis. This measure delivered the Programme for Government commitment to extend eligibility for medical cards to persons with a terminal illness and work is continuing to develop a legislative framework to underpin this administrative scheme. Medical cards awarded on end of life grounds are never re-assessed by the HSE thereby providing reassurance and comfort to patients and their families.

Separately, I can advise the Deputy that, since 2015, medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer. Further information can be found on the HSE’s website at www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/emergency-medical-cards/.

I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.