Questions and Answers: Health Bill 2008, Medical Cards for People Aged 70 and over
The Government has published new legislation about medical cards for over-70s. What does it contain?
The government has decided to end the “automatic entitlement” to a medical card for people aged 70 and over, but the changes will nonetheless see the vast majority of people aged 70 and over retain their medical card.
The Bill will implement these changes. It means
If you are now aged 70 or over
•you can continue to use your medical card into the New Year. There is no change for you on 1st January.
•From 2nd March next, you will continue to have your a medical card, so long as your income is below €700 a week (for a single person) or €1,400 a week (for a couple).
•Only if your income is above these limits, from 2nd March 2009, you will no longer have a valid medical card. However, you may still apply for, and receive, a medical card if your health circumstances cause you undue financial hardship.
If you turn 70 in the New Year
•if your income is below the limits, you will be entitled to a medical card and will receive one if you apply to the HSE.
Will you be contacted by the HSE?
Early in the New Year, after the Bill becomes law, the HSE will write to all medical card holders now aged 70 and over informing them about the new arrangements.
If your income is below the new limits, you will simply keep your card and continue to use it as normal.
Only if your income is above the income limits will you be required to notify the HSE by 2nd March – until then you can continue to use your medical card.
However, 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. You need do nothing – just continue to use your medical card.
That is the position set out in the new Bill.
Will there be a means test?
If you are aged 70 or over now – No
If you are aged 70 and over before 31st December 2008 and you have received a medical card from the HSE before that date, you will not have to undergo a means test.
Only if your income is above €700/€1,400 (single/couple) a week, will you have to declare this to the HSE by 2nd March 2009. However, you will not have to provide the HSE details of your income and assets in this declaration. The declaration is not a means test. You will simply confirm that your income is above the limits.
In the New Year, the HSE will stand ready to assist you in assessing your situation and making the declaration.
If your income is above the limits, you may still apply to the HSE for a discretionary medical card, on the basis that your health circumstances cause undue financial hardship. This application would involve a means test.
If you are under 70 now
If next year you turn 70, and your income is below the limits, you will be entitled to a medical card.
•If you do not currently have a medical card, you will be able to get one by applying to the HSE. This will involve a new and simplified means test to establish that your income does not exceed €700/€1,400 a week.
•If you currently do have a medical card, as a result of a means test or otherwise, you will only have to apply for a new medical card when your current card expires, using the new, simplified means test.
What does income mean? Is it gross income or net income?
Gross income is any income you receive, e.g. in the form of a pension or through investments or savings, rental income on properties or, if applicable, part-time employment.
It is income before tax or other deductions.
In regard to rental income, this is the rent received after necessary costs associated with the rental of a property.
Gross income was chosen because it is often easier for people to know what their gross income is.
Are there any exceptions to what counts as income?
Yes. The Bill 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 Nursing Homes charges repayments scheme.
How are savings treated?
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.
If you have savings and similar investments, income earned on the first €36,000 for a single person and €72,000 for a couple is exempt and is not counted towards gross income.
For example, if you are single and you have €50,000 earning 5% interest, the income is counted as 5% of €14,000 (€50,000 less €36,000), €700 a year or €13.46 a week.
What happens to people whose income is above the limit?
If they are already 70 or over, they can continue to use their medical card validly until 2nd March next year, but not after that.
Early in the New Year, the HSE will write to everyone aged 70 and over who currently have medical cards, setting out the position. The vast majority – those whose incomes are below the limits – will have to take no action and will continue to use their medical cards.
People whose gross income is above €700/€1,400 (single/couple) a week will be asked to declare this to the HSE by 2nd March in a simple form supplied with a prepaid envelope.
They will be offered assistance in assessing their situation.
They will also be told that they may still apply for a medical card if their health circumstances cause them undue financial hardship.
What happens if my gross income exceeds €700 per week and I am in a private nursing home or have significant medical expenses, am I eligible for a medical card?
Where a person aged 70 or over does not qualify for a medical card after 1st January, by virtue of their gross income being over the thresholds of €700 per week for a single person or €1,400 per week for a couple, the Health Service Executive (HSE) may grant a medical card or GP visit card under the existing net income thresholds, which allow for medical, nursing and other expenses to be taken into account.
In addition to the above, the HSE may issue a medical card on a discretionary basis, if the applicant would otherwise be caused undue hardship in providing general medical and surgical services for himself / herself and any dependants.
What will happen on 1 January 2009?
The old scheme of automatic entitlement to a medical card for all persons aged 70 and over will end on 31st December 2008. It will be replaced on 1 January 2009 by a scheme under which everyone aged 70 and over, whose income is below the specified limits, will be entitled to a medical card.
All existing medical cards for people aged 70 and over will continue to be valid after 1 January 2009. Only people whose income is above the limits will not have a valid medical card from 2nd March.
From 1st January, people who reach age 70 will be able to apply for, and receive, a medical card if their income does not exceed the €700/€1,400 threshold.
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 income does not exceed €1,400 a week.
What will be the situation for other dependants of people aged 70 and over who are not 70 themselves?
The medical card will cover the dependants of a person aged 70 and over.
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.
Will the income limits be increased each year?
The Government has made a commitment to take account of cost of living increases each year in reviewing the income limits over the lifetime of this Government.
The Bill 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 medical cards now have to pay the 2% ‘Health Levy’ on their income?
No. The Bill 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.
Health Bill 2008
Health Bill 2008- Explanatory Memorandum