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Medical Card Benefits

Thursday, 25 February 2010

Teresa Mc Court - Citizens Information Services

Teresa Mc Court has been the Development Manager with Co Westmeath Citizens Information Service since 1997. The service runs 2 full time Citizens Information Centres, one in Mullingar and one in Athlone and Outreach centres in Castlepollard and Kilbeggan.

The service dealt with over 32,000 queries from members of the public in 2008 alone. The figures so far for 2009 are showing a marked rise on last year with close to 3000 queries in each of the first 2 months. The main issues people have are Employment, Social Welfare Heath and Housing, but the service also deals with queries on Education, Tax, Immigration and many other topics.

Every effort is made to provide a high quality comprehensive and confidential service to the public. The service is free.

Teresa began her career as a civil servant working in the Department of Agriculture and the Department of Social Welfare. She studied Public Administration, Community Development , Psychology and also completed a Diploma with Open University in the Management Voluntary and Non Profit Organisations.

She remains actively involved in Community affairs in a voluntary capacity. She is a Board member of Athlone Community Services Council, Dr. Stephens Centre for the unemployed, The Midlands Support Agency and Citizens Information Phone Service.
In her role as a Development Manager she has initiated programmes such as a weekly "know your rights" slot on local radio which has been extremely successful.

The service runs public Information workshops on topics such as Pensions, Wills and Inheritance. And also gives presentations to Community groups on request.

In light of the economic crisis queries at the Westmeath CIC have become increasingly complex as more and more people are faced with unemployment

A medical card issued by the HSE allows the holder to receive certain health services free of charge.

Q: What is a Medical Cards?

Medical Cards allow people to access Family Doctor or GP services, community health services, dental services, prescription medicine costs, hospital care and a range of other benefits free of charge.

Most people who get a Medical Card do so because their income is below a certain level. It is also possible to get a Medical Card if the costs of meeting your medical needs causes you financial hardship, or if you have entitlement under EU regulations.
Medical Cards are issued by the HSE's 32 Local Health Offices nationwide, and these offices also accept and carry out the assessment of your application.
For Medical Card Applications, the HSE only considers your income after tax and PRSI is deducted, rather than total income. We also make allowances for expenses on childcare, on rent and mortgage costs and on travel to work.

Q: How do we qualify for a medical card?

To qualify for a medical card your weekly income must be below a certain figure for your family size. Cash income, savings, investments and property (except for your own home) are taken into account in the means test.

Normally, your dependent spouse and children are also covered for the same range of health services. Medical cards are small plastic cards (similar in size to a credit card). Your medical card will show your doctor's name. It is usually issued for a year, after which it is reviewed.

Medical card holders are exempt from paying the Health Levy part of social insurance and from the Income Levy introduced in 2009. They may also be exempt from paying school transport charges, State exam fees in publicly-funded second-level schools. There may also be financial help with buying school books in certain schools GP Visit Cards: Unless you have a medical card, visits to GPs (family doctors) are not free. If you do not qualify for a medical card on income grounds, you may qualify for a GP Visit Card. It is means tested, but the income limits are 50%higher than for the medical card.

Q: What health services are normally covered?

If you have a medical card, you are entitled to:
. Free GP (family doctor) services
. Prescribed drugs and Medicines (with some exceptions)
. In-Patient public hospital services out-patient services and medical appliances
. Dental, optical, aural services
. Maternity infant care services
. Some personal and social care services, for example, public health nursing, social work services and other community care services
. A maternity cash grant of €10.16 on the birth of each child.

Q: What has occurred since the Budget 2010?

A 50 cent charge per prescription item is being introduced for medical card and Long Term Illness Card holders, subject to a monthly ceiling of €10 per family. New legislation is required to give effect to this; the expected implementation date is 1st April 2010.

Q: What are the Income guidelines for medical cards?

In general, if your sole income is the maximum rate of a means-tested payment, you will be granted a medical card without having to undergo a further means test. If your weekly income comes solely from a Social Welfare allowance or benefit or from a HSE allowance you may be given a medical card, even if your income is in excess of the guidelines for your age and situation.

The assessment of a couple for medical card purposes is based on the age of the older person.

Q: What again are the New rules for Over 70s Medical Cards?

January 1 2009
The Health Act 2008 has brought changes to medical card entitlement for people aged 70 years and over.

Under the new legislation, from 1st January 2009 everyone aged over 70 who applies for a medical card will be subject to a means test. The automatic entitlement to a medical card for this age group has ended.

The HSE wrote to every medical card holder aged 70 years and over, outlining the changes that have occurred and asked those who received their medical card on the basis of age only (without a means test) to make a declaration on their income before 2nd March 2009.

What about people who have a medical card issued before 31 December 2008
All existing medical cards for people aged over 70 were valid until 2 March 2009. After that date, they remain valid if the person's income is below the relevant new threshold. The 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.

The HSE wrote to all people aged 70 and over informing them about the new arrangements. Only people who have income above the limits were asked to reply to the HSE. Everyone else simply keeps their card.

All medical cards have an expiry date and are subject to review. In general medical cards currently issued under the Health Act 2008 to people aged 70 and over are issued for a period of 2 years.

Q: What are the income guidelines Income guidelines if you are aged under 70 years?

Lone parents with dependants are assessed under the income limits for married persons.

Weekly income limit (Gross, less tax and PRSI)

. Single person living alone Aged under 66 €184 Aged 66-69 €201.50

. Single person living with family Aged under 66 €164 €173.50
. Married couple (or lone parent with dependent children) €266.50 €298
. Allowance for each of first 2 children aged under 16 €38 €38
. Allowance for 3rd and each subsequent child under 16 €41 €41
. Allowance for each of first 2 children aged aged over 16 €39 €39
(with no income)
. Allowance for 3rd and each subsequent child over 16 €42.50 €42.50
(no income)
. Each dependant over 16 years in full-time third-level €78 €65
education,who is not grant aided

Q: Will expenses also be allowed for?

Reasonable expenses incurred in respect of childcare costs and rent/mortgage payments will also be allowed. (There is however, no exact definition of what 'reasonable expenses' actually means in relation to housing or childcare costs).
Weekly travel costs to work: The actual cost of public transport is allowable or, for car owners, mileage at 30 cent per mile/18 cent per km plus a weekly amount of €50 to cover standing charges (depreciation and running costs). Where a couple needs two cars to travel to work a double allowance applies.

Q: What other categories of people that are eligible for the medical cards?

Medical cards are usually granted to children in foster care.
. You may be entitled to a medical card under EU Regulations:
. You are living in Ireland and receiving a social security payment from another European Union/European Economic Area (EU/EEA) country or Switzerland and you are not getting an Irish social welfare payment (apart from Child Benefit or Early Childcare Supplement). You must not be employed or self-employed, that is, liable to pay PRSI)
. You are living in Ireland and working in another EU/EEA country or Switzerland and are liable to pay social insurance contributions in that country
. You are living in Ireland and you are the dependent spouse or child of someone employed in another EU/EEA country or Switzerland. You must not be getting an Irish social welfare payment apart from Child Benefit or Early Childcare Supplement and you must not be liable to contribute to the Irish social welfare system, that is, pay PRSI on income.
. Full-time students aged 16-25 who are financially dependent on their parents are normally only entitled to a medical card if their parents have one. Students who are financially independent of their parents, for example, who have income from part-time work, and who satisfy the means test may be entitled to a medical card. In this case, the Local Health Office where the student is attending college would issue the medical card. A student getting Disability Allowance will generally be entitled to a medical card.

Return to work

If you are receiving a social welfare payment and return t work , you may retain your medical card for up to 3 years.

If you move house

You can use your medical card for up to 3 months if you are living temporarily in a different area. In this case, you can attend any GP in the area participating in the medical card scheme. If you are going to be away longer than 3 months, you should apply to the Local Health Office of that area, for a medical card. If you move to a different part of your own HSE Administrative Area, you can apply to change your doctor.

Q: How to do we apply for a medical Card?

You can get the application form and a list of participating GPs from your Local Health Centre or Local Health Office for your area. Alternatively, you may download a medical card application form:

. Form MC1for people under 70 years and people aged over 70 whose income is above the €700/1,400 limit

. FormMC1afor those aged over 70 whose income is below the €700/1,400 weekly income limit

  • You complete it and bring it to the GP you have chosen from the list of participating doctors
  • The GP you select must generally have his/her practice within 7 miles of where you live.
  • The GP must agree to accept you as a patient. Read more about GP services for Medical Card holders here.
  • If the GP accepts you as a patient, he/she signs the form. Your employer also has to sign the form and certify your earnings or if you are claiming a social welfare payment, the form has to be stamped at the Social Welfare Local Office. Self-employed people have to submit their most recent tax assessment form or set of trading accounts.
  • The application form should be returned to the Local Health Office if you are aged under 70. If you are aged over 70 you should return the form to the HSE Primary Care Reimbursement Service.
  • If you are under age 70 and your income is above the guidelines you will automatically be assessed for the GP Visit Card. If you are over 70 years old, you will only be assessed for a GP Visit Card if you a applying for the general medical card instead of the over 70s card.
  • You can also apply for the Drugs Payment Scheme at any age.You can track the progress of your medical card application at

Can you appeal Appeals this decision?

If you have been refused a medical card and are not satisfied with the decision, you may have it reviewed at your Local Health Office. Your circumstances may have changed or you may have left out some relevant information from the original application. If following this you are still not satisfied you may make an appeal to the Appeals office of you HSE AreaThe contact details will also be contained in your letter of refusal). The Appeals Office will conduct a reassessment of your application. This will be conducted by HSE staff not involved in deciding on your original application