The Health Act 2008 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.

Medical Card Applications for everyone in this age group are now processed centrally in our Client Registration Service, Finglas, Dublin 11.

Information is available on this website and from the Client Registration office on Call Save 1890 252 919

Questions and Answers:
The scheme of automatic entitlement to a Medical Card for all persons aged 70 and over ended on 31^st December 2008.  It has been replaced from 1^st January 2009 by a scheme under which everyone aged 70 and over will be entitled to a Medical Card if their weekly gross income is below €700 for a single person and €1400 for a couple.

People who reach age 70 can apply for, and receive, a Medical Card if their gross income does not exceed the €700/€1,400 threshold.

Is there a separate application form to apply for the Over 70’s Medical Card after1st January 2009?
Do I have to visit my local health office when I have the form completed?
What does income mean?  Is it gross income or net income?
Are there any exceptions to what counts as income?
How are savings and similar investments treated under the new scheme?
If my spouse has savings in his/her bank account, will that effect my entitlement?
I have a summer home in Spain which my family and I use.  Will that affect my claim for the over 70’s Medical Card?
If my income is €10 per week in excess of the income limits, will I be entitled to the over 70’s Medical Card, as I spend more than that on medication?
Is there any increase in the income limits for couples under the over 70 scheme who have a child dependant?
What about someone who is under 70 now and married to someone over 70?
What happens if my spouse & I separate?
We have guardianship of our grandchildren, is there provision that I can get them on my over 70’s Medical Card?
Will all my medical bills be taken into account when assessing me for the over 70yrs Medical Card?
If I am in a nursing home, can my nursing home costs be taken into account under the new scheme when assessing my income? 
If I make payments in respect of Maintenance to my spouse will that amount be exempt when assessing my application?
I am getting a Respite Care Grant as I am a Carer for my spouse, is that grant taken into account in the assessment?
How often will my entitlement be reviewed?
Will the income limits be increased each year?
Will people over 70 who don’t have a Medical Card now have to pay the 2% ‘Health Levy’ on their income?
Do medical card holders pay the Income levy that came into effect on the 1st January 2009?
I am 70 years old and have moved from an EU Member State to reside in Ireland. Am I entitled to a medical card?
New Over 70’s Medical Card Review Process
How does the new Over 70 Review Process work?
Are the assessment/review rules or requirements any different to the national assessment guidelines?

Is there a separate application form to apply for the Over 70’s Medical Card after1^st January 2009?
Yes, and application forms are available from this website in the Medical Card Section or from your Local Health Office.

There are now 2 Medical Card Application Forms:

Form MC1A - for people aged over 70 whose income is BELOW the €700/1400 income limit.

Form MC1 - for those aged 18-69 and people aged over 70 whose income is above the limits above.

If you are over 70, and believe your income may be above the limits, you may still apply to the HSE for a Medical Card under the general Medical Card / GP Visit Card scheme, on the basis that your health circumstances cause undue financial hardship. The General application form MC1 is the appropriate form to complete in this instance.

Do I have to visit my local health office when I have the form completed? 
No, you can post the form back to a central office; the address will be given with information on ‘How to complete the Form’.  However, at all times you will be able to seek advice from your local health office or call the Client Registration office on Call Save 1890 252 919 for information.     

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What does income mean?  Is it gross income or net income?
It is gross income.  Gross income is any income you receive, e.g.:

• In the form of a pension (social welfare, occupational or private)
• Employment – fulltime/part time, self employment, directorships
• Through investments or *savings **Rental income on properties.

In essence, gross income is income before tax or other deductions.

In regard to rental income, this is the rent received, less necessary expenditure associated with the rental of a property.

In regard to a self employed person the assessable income is determined as the average weekly Gross Income including trade capital allowances.

Are there any exceptions to what counts as income?
Yes, the legislation excludes specific compensation/redress awards and payments from the calculation of gross income for the purposes of the legislation.

These are payments under the Hepatitis C Compensation scheme, the Lourdes Hospital Redress scheme, the Residential Institutions Redress scheme and under the Nursing Homes charges repayments scheme.

How are savings and similar investments treated under the new scheme?
Savings or similar investments of €36,000 for a single person and €72,000 for a couple are disregarded. The remainder of savings and similar investments will be assessed on the income calculated at a notional interest rate based on the prevailing interest rates at the time of application. The Central Application Unit will review the notional rate on a quarterly basis.

Alternatively where an applicant wishes to have the actual interest from savings / investments applied, and provides a certificate of interest paid on his/her savings in the last full calendar year, the HSE will apply this approach and use the most beneficial option in favour of the applicant (subject to submission of the appropriate certificates from the relevant institutions).

In this context it should be noted that in the case of some “longer term” investment accounts, where the interest is only applied at the end of a fixed period, if the client so wishes the HSE will only take account of the interest earned on the date the investment matures. The alternative is as above. i.e. an annual  notional rate will be applied

In essence, only the interest or income earned on savings and similar investments will be counted as income, not the total values of the savings or investments themselves.

For example, if you are single and you have €50,000 earning 3% interest, the income is counted as 3% of €14,000 (€50,000 less €36,000), €420.00 a year or €8.05 a week.

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If my spouse has savings in his/her bank account, will that effect my entitlement?
Yes, as couples are jointly assessed.  However, in the case of a couple, the income on the first €72,000 of capital is not assessed 

I have a summer home in Spain which my family and I use.  Will that affect my claim for the over 70’s Medical Card?
Not generally.  The family home and any other property will not be taken into account, unless you have an income from it, i.e. the house / land / property is leased or rented.

If my income is €10 per week in excess of the income limits, will I be entitled to the over 70’s Medical Card, as I spend more than that on medication?
No, if your income is in excess of the single €700 gross income limits or the couple €1,400 gross income limits, you are not entitled to an over 70 Medical Card.  However, if you have high medical expenses, you can have your income and outgoings assessed under the general Medical Card scheme, where all your circumstances will be considered in order to determine if you have entitlement to a Medical Card or GP Visit Card.

Is there any increase in the income limits for couples under the over 70 scheme who have a child dependant?
No, but the couple rate has been set at double the single rate.

What about someone who is under 70 now and married to someone over 70?
If one member of the couple is aged 70 or over, they will both qualify for a Medical Card if their combined income does not exceed €1,400 a week.  The Medical Card will cover the dependants of a person aged 70 and over, i.e. spouse (U/70 or O/70) and child dependants.

What happens if my spouse & I separate?
If both of you are over 70 you will both be assessed as single people under the O/70 Medical Card Scheme, with an  the income limit of €700 per week.

If one of you are under 70 s/he will be assessed under the general Medical Card/GP Visit Card Scheme.

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We have guardianship of our grandchildren, is there provision that I can get them on my over 70’s Medical Card?
Yes, you can have your spouse and child dependants included on the over 70’s Medical Card.

Will all my medical bills be taken into account when assessing me for the over 70yrs Medical Card?
No, there is no provision under the over 70’s Medical Card scheme for any outgoings like rent payments, child dependant costs, cost of medicines, cost of health care, etc.  If your have high medical costs and you do not qualify for the over 70’s Medical Card, you can be assessed for the Medical Card / GP Visit Card under the general Medical Card / GP Visit Card scheme.  This assessment takes into account all outgoings, including health related expenses.

If I am in a nursing home, can my nursing home costs be taken into account under the new scheme when assessing my income? 
No, there is no provision under the over 70’s Medical Card scheme for any outgoings like rent payments, child dependant costs, cost of medicines, cost of health care, etc.  If your have high nursing home costs and you do not qualify for the over 70’s Medical Card, you can be assessed for a Medical / GP Visit Card under the general Medical Card / GP Visit Card schemes.  This assessment takes into account all outgoings, including health related expenses incurred, e.g. nursing home costs.

If I make payments in respect of Maintenance to my spouse will that amount be exempt when assessing my application?
No, there is no provision under the over 70’s Medical Card scheme for maintenance payments. If you have high maintenance payments and you do not qualify for the over 70’s Medical Card, you can be assessed for the Medical Card / GP Visit Card under the general Medical Card / GP Visit Card scheme.  This assessment takes into account all outgoings, including maintenance payments.

I am getting a Respite Care Grant as I am a Carer for my spouse, is that grant taken into account in the assessment? 
Yes, all income is taken into account in the over 70s Medical Card assessment, except non-cash benefits, e.g. free electricity, free travel, free TV license.

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How often will my entitlement be reviewed? 
A random audit will be carried out on all Over 70 Medical Card holders.  If selected, the Medical Card holder will be informed of same and asked to submit up to date income details, which will be subsequently checked by the HSE using both Department of Social & Family Affairs and Revenue information re incomes. 

Will the income limits be increased each year?
The legislation requires the Minister for Health and Children to review the income limits in respect of persons aged 70 or over each year by reference to changes in the Consumer Price Index.

Will people over 70 who don’t have a Medical Card now have to pay the 2% ‘Health Levy’ on their income?
No, the legislation provides that all persons aged 70 and over will be exempt from the Health Contribution (the ‘Health Levy’), no matter what their income is or whether they have a Medical Card or not.

Do medical card holders pay the Income levy that came into effect on the 1^st January 2009?
No, you do not pay the income levy if you have a full medical card.

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I am 70 years old and have moved from an EU Member State to reside in Ireland. Am I entitled to a medical card?
EU pensioners resident in Ireland and who are in receipt of a qualifying pension, as evidenced by form E121, are entitled to a Medical Card provided they are not subject to Irish social security legislation. Pensioners from the UK must provide proof that they are in receipt of a UK social security pension.

Dependants resident in Ireland of pensioners with entitlement under EU legislation are entitled to a medical card on production of form E121 provided the dependants are not subject to Irish social security legislation.

New Over 70’s Medical Card Review Process
A new Over 70’s Medical Card review process is being introduced this week in the Central Office in Finglas (PCRS).  A simplified declaration process is replacing the more onerous review application form for medical card holders aged 70 years and over that come up for review by the Central Office.

The new declaration comprises a single page form that can be completed with a single entry, signed and dated, in the event that the circumstances of the medical card holder and his/her dependants have not materially changed since their last review, or their initial application if this is their first review.

This is recognising the fact that the financial circumstances of most medical card holder aged 70 years or over are unlikely to change significantly.  The vast majority of such clients continue to hold eligibility on review. 

A copy of the letter and new single page form for Over 70 reviews are attached for your information.  Please note that pages two and three are printed back to back (i.e. on a single sheet), with the back page for information purposes, and to allow the applicant to correct any error showing in their personal details.

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How does the new Over 70 Review Process work?
Three months in advance of the review date for an Over 70 client the Central Office will send out the attached letter and single page declaration/consent form.

If we have not heard back from the client in four weeks a reminder letter will issue.

If the client is satisfied that his/her financial circumstances have not changed to the extent that s/he may no longer be entitled to a Medical Card s/he simply reads the declaration and consent, signs and dates it, puts in their telephone number and returns it to us at the address provided.

If the client thinks that his/her financial circumstances have changed to the extent that s/he may no longer be entitled to a Medical Card, and s/he wishes to apply for a full review in order to determine if s/he still falls within the financial guidelines under the new scheme, s/he can complete a normal Over 70’s review form and submit it in the normal way.  If they know that they are over the Gross income limits set out under the new scheme, they can also still apply under the main scheme to retain their medical card on discretionary grounds, in the normal way.

Are the assessment/review rules or requirements any different to the national assessment guidelines?
No, this new process simply recognises the fact that the financial circumstances of clients aged 70 years and over do not, in the vast majority of cases, change significantly, and also takes cognisance of the worry and upset that formalities and form filling can cause to some vulnerable clients in this cohort.

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For information on how to apply for a Medical Card, visit our Medical Card Section

or

Call the Client Registration office on Call Save 1890 252 919 to speak to our staff or visit your Local Health Office.