The medical card can be worth its weight in gold, especially to the parents of young children with limited means. Being able to retain it after a period of unemployment can make all the difference to people who move off the Live Register to get a job or who take the risk of becoming self-employed.

Keeping a medical card after a period out of work can provide the confidence that your health and that of your family's is covered.

But there is extraordinary confusion about the criteria for retaining the medical card after being unemployed.

A Department of Health spokesman confirmed that anyone who has been on the Live Register for more than a year and who gets a job or becomes self-employed is entitled to keep the medical card for three years.

The spokesman also confirmed that the entitlement to retain the card for three years applies to people who have been on unemployment assistance for more than a year and anyone who received unemployment benefit for more than a year.

He also confirmed that self-employed people who have proved their eligibility for unemployment assistance or unemployment benefit are also entitled to keep the medical card for three years after they sign off the live register.

A spokesman for the Department of Social, Community and Family Affairs explains that people who have proved their eligibility for unemployment assistance or unemployment benefit are entitled to do casual work and to sign on for the days they do not work.

He confirmed that people on the Live Register continuously for a year will qualify for the three-year extension of the medical card but that if they sign off during that year that would preclude them.

He said that casual workers are not regarded as having signed off the Live Register unless they work for a full week. So casual workers can retain the medical card for three years so long as they have signed on for more than a year.

He also said that if it is more than a year since casual workers first signed on despite legitimately doing casual work for a few days a week during that time - they are entitled to keep the medical card for three years.

The Department of Health spokesman said that these four categories of people signing on for more than a year - people eligible for unemployment assistance, unemployment benefit, casual workers on the Live Register and self-employed people who have proved their eligibility for the register because of their low incomes - have an automatic entitlement to retain the medical card for three years.

He also confirmed that the entitlement to retain the medical card for three years is not dependent on joining a Government scheme like the new revenue job assist programme, the back to work programme or a community employment scheme. Getting any job or entering any self-employment in itself guarantees the three-year retention of the medical card.

He said that the three-year retention of the medical card is to encourage people to enter the world of work.

People who have been on the register for a year are exempted from the normal means tested criteria (see panel).

If a person who has been unemployed for more than a year gets a well-paid job, he or she is nonetheless entitled to keep the medical card for three years although out of civic responsibility the person could elect not to use it, according to the source.