The Government has bowed to pressure and increased the eligibility threshold set for medical cards and GP visit cards issued to those aged 70 or over.
Under the original plans put forward in the Budget on Tuesday, anyone aged 70 or over who had a net weekly income of less than €201.50 for a single person living alone, €173.50 for a single person living with family, or €298 for a married couple would qualify for a medical card.
This limit has now been increased to €240.30 for a single person, or €480.60 for a couple, which is the same as the highest amount of a State contributory pension. Those who earn above this threshold will be questioned further.
The means test does not include social welfare payments such as the fuel allowance or the living alone allowance. Savings up to up to €36,000 for a single person and €72,000 for a couple are also excluded, as is the family home.
Expenses will also be taken into account, such as rent or mortgage costs, GP expenses, medication, nursing home fees and income tax or PRSI.
There are approximately 350,000 people aged 70 and over who have medical cards in the State. Some 211,000 of these had a medical card on turning 70, which means they had already been subjected to a means test at some point.
It was feared that many of the remaining 139,000 who applied on turning 70 would lose their entitlement to the card.
The income thresholds for doctor-only medical cards have also been increased. Originally, the Government planned to set a threshold for a single person aged 70 or over living alone of €302. The department of Health said today the income limit would be set at €360.45 for a single person or €720.90 for a couple.
Those whose income exceeds both these thresholds may qualify for the Health Support Payment if their gross weekly income is less than €650 for a single person, and €1300 for a couple. The support payment pays out €400 a year for single people and €800 for couples.
The new rules will come into effect on January 1st 2009.
The decision to remove the automatic right to medical card for the over-70s has been widely criticised since it was announced as part of the Budget. Fine Gael leader Enda Kenny described it as as a brutal attack on the elderly in our society, while Labour's health spokeswoman Jan O'Sullivan said it was "mean-spirited".
Speaking on RTE's
Six One Newsthis evening, the Minister for Health, Mary Harney, defended the Government's decision.
"This was a very difficult budget. We had to frame the budget against very tough economic circumstances. We had to make decisions we wouldn't have even considered a couple years ago. We were faced with a situation where the public finances in this country had rapidly deteriorated and in that context, we had to make choices," she said.
"The vast majority of people aged 70 or over, about 70 per cent of them will get a full medical card. A further number - up to 8 out of every 10 will see their doctor free of charge."
Following today's announcement of the changes to the scheme, Ms O'Sullivan described the alterations as "minor" and said it would "do little to undo the damage that will be inflicted on the elderly, if the government persists with its decision to withdraw their entitlement to free cards".
"This adjustment will result in only a marginal reduction in the €100m that the government plans to take back from pensioners by scrapping the scheme," she said.
"Rather than tinkering around with the threshold by a tenner here and a tenner there, the government should abandon the budget decision and end the uncertainty and fears that are now stalking elderly citizens. For couples over 70, these limits will still be well below those that applied immediately before the budget."
Fine Gael health spokesman Dr James Reilly said the Government had been forced into "a desperate climbdown", but warned that adjusting the income limits was not good enough.
"The Government can forget it if they think they're getting a pat on the back for this move on income limits," he said.
"The truth is this is a desperate climbdown from a Government that has been pressured into action after their vicious attack on the elderly. It's not good enough and Fine Gael will continue to pressure for a full reversal of
this unjustifiable, mean-spirited, cold-hearted measure."
Age Action welcomed the decision to increase the income thresholds, but said more needed to be done to avoid causing "untold hardship" to older people.
"The Minister has essentially just tweaked the thresholds, but the bottom line is the same - a person or couple on the basic state pension will still fail the means test and be refused a medical card if they have any other income," said Age Action spokesman Eamon Timmins.
"While Government members have highlighted their concern that under the current system people with large pensions are entitled to medical cards, under the proposals due to come into effect in January people with just a few euro above the state pension will lose their entitlement to a medical card. People in this situation simply will not be able to pay for these medicines and services from their own resources."
