Despite its name, a “medical card” is generally allocated on financial grounds rather than on grounds of illness.
This was outlined in the Health Act 1970, which says the assessment for a card is determined by reference to the means, including income and expenditure, of a person and their partner or dependants.
The threshold for a single person under 65 living alone is €184 a week, but all sorts of other factors are taken into account – savings, mortgage payments, childcare costs, travel-to-work expenses, etc.
The thresholds for people over 65 are higher, and far higher for over-70s, though the latter have been reduced in recent budgets.
The threshold for a GP visit card, which provides for free doctor visits but no other benefits, is 50 per cent higher than for full medical cards.
Almost two million people, or 43 per cent of the population, are covered by either a medical card or a GP visit card. The number of cards has increased by 74 per cent since 2005, as a result of increasing unemployment and an ageing population.
Cards are normally issued for three years. Rules on qualifying were tightened in last year’s budget, which disallowed the first €50 of travel-to-work costs and the cost of serving home improvement loans in assessing eligibility.
Other routes
A person who does not qualify on income grounds can acquire a card following undue hardship caused by medical or social circumstances.
A card can be issued on a discretionary basis. Factors taken into account include illness leading to financial hardship, the cost of providing medicines and related items, cost of treatment, transport costs to hospitals, addictions such as drink, drugs or gambling and “social deprivation”.
Medical cards are also issued in emergency circumstances for six months, on foot of information from a doctor. The HSE also issues cards to patients with a terminal illness; no means test applies.
A medical card entitles the bearer to other State services, including a small maternity cash grant, exemption from school transport charges and State exam fees, and help with buying schoolbooks.
