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The Government has announced that with effect from 1 January 2009 new income thresholds will apply for medical cards for people aged 70 and over.
The current arrangements for medical cards will continue to apply until the end of this year. Rules for over 70s Medical Card What is a medical card? A medical card is issued by the HSE and it is a similar size to a plastic credit card. People who have a medical card are entitled to a range of Health Services free of charge. What Health Services are available free of charge if I have a medical card? If you hold a medical card you are entitled to the following services:
· Doctor Visits – A range of family doctor or GP services from a chosen doctor contracted to the HSE in the local area.
· Prescription Medicines: The supply of prescribed approved medicines, aids and appliances such as wheelchairs, crutches etc.
· Certain Dental, Ophthalmic (Eye) and Aural (Ear) health services
· Hospital Care – all in-patient services in public wards in public hospitals, which includes public consultant services.
· Hospital Visits – all out-patient services in public hospitals that include public consultant services.
· Maternity Cash Grant for the birth of each child
· Medical and Midwife Care for mothers, which include health care related to pregnancy and the care of the child for six weeks after birth
· Some personal and social care services – public health nursing, social work services etc
Am I Entitled to a Medical Card? If you are a resident in the State and over 16 years, you are entitled to apply for a medical card. A resident means you are living in the State for a minimum of one year or you intend to live in the State for a minimum of a year. You can qualify for a medical card under the following headings:
· Means Test: Single people of families who have an income within certain financial guidelines should read more at http://www.hse.ie/eng/Find_a_Service/entitlements/Medical_Cards/70medicalcard.html
· Undue Hardship: People over the financial guidelines, but the HSE decide that the financial burden of medical circumstances would cause undue hardship.
· Automatic: People who are automatically entitled to a medical car are
- People with an European Union entitlement
- People who are entitled to retain their medical card under government schemes
- People over 70, until December 31 2008. To Qualify for a Medical Card by Means Testing If a person’s only income is a means tested Social Welfare Allowance, they will qualify for a medical card. A person and their spouse or partner will also get a medical card if their income is below the medical card income guidelines (link below). A person’s means includes any income, property, investment and savings. The HSE make an assessment for a medical card by assessing a person and a spouse’s income after Tax and PRSI are deducted. For more information please read these guidelines http://www.hse.ie/eng/Find_a_Service/entitlements/Medical_Cards/MCGPVCincomeguidelines.pdf. To Qualify for a Medical Card on the Grounds of Hardship If a persons income is above the HSE income guidelines, people may still be entitled to a medical card on the grounds that paying for medical costs causes a person undue financial hardship. To Qualify for a Medical Card by Automatic Entitlement People who are ordinarily resident in Ireland automatically qualify for a medical card by completing an application form. To automatically qualify for a medical card a person must have EU entitlement or be entitled under Government Schemes. If you are aged 70 years or over Changes were announced to Medical Card Eligibility for those aged 70 years and over in October 2008. From January 1 2009, the automatic entitlement to a medical card on reaching 70 years will cease. For more information please click here http://www.hse.ie/eng/Find_a_Service/entitlements/Medical_Cards/70medicalcard.html If you have EU Entitlement If a person belongs to one of the following groups, they will get a medical card under EU Regulations:
· Living in Ireland and receiving a social security payment from another European Union/European Economic Area (EU/EEU) country or Switzerland and you are not getting an Irish social welfare payment (excluding from Child Benefit or Early Childcare Supplement). You must not be liable to contribute to the Irish Social Welfare System e.g. PRSI.
· Living in Ireland and working in another EU/EEA country or Switzerland and are liable to pay Social Insurance Contributions in that country.
· Living in Ireland and you are the dependant spouse or child of someone employed in another EU/EEA country and Switzerland. A person must not get an Irish Social Welfare Payment apart from child benefit or early childcare supplement and must not be liable to contribute to the Irish social welfare system. Can I retain a medical card if I return to work? · People who participate on certain Government Employment and Education scheme will retain their entitlement to a medical card for the duration of the scheme, e.g. Back to Work Allowance, Community Employment Schemes etc
· People who have been unemployed of a one parent family payment for a minimum of 12 months will have their medical card for a length of 3 years if they start employment
· If a person has been unemployed for 12 months or more begins part-time employment, their medical card will be retained for a length of 3 years from the date their income increases to a level that exceeds the appropriate Medical Card Guideline.
· People who have a medical card and are in receipt of a Disability Allowance or a Blind Pension from the Department of Social and Family Affairs and who take up employment can hold on to their medical card for a maximum of 3 years from the date of starting employment. Dependent members of the family of those covered by the ‘retention’ provisions will also be granted medical cards. How long does a medical card last? The card is usually issued for one year and then it is reviewed. It all depends on a person’s circumstances and could be issued for a longer period. When can I apply? You can apply for a medical card at any time. How do I apply? Medical card applications are available from your Local Health Centre, a Local Health Officer or www.hse.ie What happens if I move to another HSE Local Health Office Area? You should contact your new Local Health Office where you will find out the GPs practising in your new area of residence. What happens when a child turns 16? People aged 16 to 25 years who are financially dependent on their parents, each get their own medical card, if their parents are eligible for a medical card. If you are not dependent on your parents, a young persons means and income will be assessed. Can I use a medical card on holiday? You can use a medical card for up to three months but contact your local HSE office to confirm details. What if I am not eligible for a medical card? A person applying for a medical card should get a decision a short time after applying. If a person is not satisfied with the decision, they may want it to be reviewed by the Local Health Office. If a person is not entitled for a medical card they will be automatically assessed for a GP Visit Card. If a person is not entitled to a GP Visit Card there are other HSE schemes that you can apply for. Below are some useful links: Drug Payment Scheme - http://www.hse.ie/eng/find_a_service/entitlements/Drugs_Payment_Scheme/ Long-Term Illness Scheme - http://www.hse.ie/eng/find_a_service/entitlements/Long_Term_Illness/ European Health Insurance Card (EHIC) - http://www.hse.ie/eng/Find_a_Service/entitlements/European_Health_Insurance_Card_EHIC_/ GP Visit Card –
http://www.hse.ie/eng/Find_a_Service/entitlements/GP_Visit_Cards/ Health Centres –
http://www.hse.ie/eng/Find_a_Service/Health_Centres/ All existing medical cards will continue to be valid after 1 January 2009 unless your income exceeds the new thresholds.
The new arrangements mean everyone aged 70 or over whose gross income is less than €700 a week (€36,500 a year) if single and €1,400 a week (€73,000 a year) for a couple can now be sure they will keep their medical card.
These new arrangements are designed to make the system as clear and user friendly as possible. They mean that:
Those whose income is less than €700/€1,400 will have a medical card;
Those whose income is over the limit may still get a medical card if their personal or health circumstances cause them undue financial hardship; and other people will be covered by the Drug Payment Scheme. 1. How many people will keep their cards?
95% of those aged 70 or over – about 330,000 out of 350,000 – will keep their cards.
2. Will you be contacted by the HSE?
The HSE will write to all medical card holders aged 70 and over informing them about the new arrangements. People whose income is below the new threshold will simply keep their cards and continue to use them as normal. Only those above the income limits will be required to notify the HSE.
If you know your income is below the limits you don’t need to wait for the letter to arrive to be sure you are keeping your medical card.
The HSE will start sending out letters in about two weeks time.
3. Why was income set at €700 for a single person and €1,400 per couple?
The new income thresholds are designed to ensure that the vast majority of persons aged 70 and over will continue to have a medical card, and that only those on higher incomes will lose their entitlement. The new income thresholds announced by the Government for persons aged 70 and over mean that, from 1 January 2009:
Retired Ministers, Ministers of State, Judges and Secretaries General of Government Departments will not qualify for a medical card;
Retired nurses, teachers and gardaí would be expected to qualify for a medical card if single or if married to someone with a similar or lower level of pension;
Retired TDs, school principals and principal officers in the civil service will not qualify for a medical card if single but may qualify if married subject to the income of their spouse. 4. Will there be a means test?
People who are aged 70 years or over and apply for a medical card after 1 January 2009 will be means tested to establish that their income is under €700/€1,400 a week.
Existing card holders will not have to undergo a means test unless their income is above the limits and they want to apply for a discretionary medical card on the basis of their personal circumstances.
There will be a means test for new applicants after 1 January 2009 to establish that their income is under €700/€1,400 a week.
People whose gross income is above €700/€1,400 (single/couple) a week will have to declare this to the HSE. In January next, the HSE will review the self-assessment process outlined above, examine the level of compliance and consider available options to confirm the information received.
Legislation to give effect to the new arrangements will provide that all existing medical cards will continue to be valid after 1 January 2009 if the person’s income is below the relevant new threshold.
5. What does income mean? Is it gross income or net income?
Income is any earnings you receive in the form of a pension or through investments or savings. What is assessed is gross income, i.e. income before tax or other deductions. It is easier for people to know what their gross income is.
The new gross thresholds are well in excess of the net limits of €360/€720 (single/couple) which previously would only have qualified an applicant for a GP visit card. 6. What about savings?
It is only the interest earned on savings that is counted as income, not the savings.
Income from savings up to the first €36,000 for a single person and €72,000 for a couple is not counted.
7. What happens to people whose income is above the limit?
The HSE will write to everyone aged 70 or over. People whose gross income is above €700/€1,400 (single/couple) a week will have to declare this to the HSE and will not be entitled to use their existing cards after 31 December 2008.
Those whose income is over the limit may still get a medical card if their personal or health circumstances cause them undue financial hardship.
The existing HSE appeals mechanisms will also continue to apply.
8. What will happen on 1 January 2009?
All existing medical cards will continue to be valid after 1 January 2009 unless the person’s income exceeds the relevant new thresholds.
Persons who reach age 70 will be able to apply for, and receive, a card in the normal way and will get a medical card if their income is below the €700/€1,400 threshold.
9. What about someone who is under 70 now and married to someone over 70?
If one member of the couple is aged 70, they will both qualify for a medical card if their income is below €1,400 a week. |
