Hundreds of thousands paying higher bills by not taking up medical cards

Among the benefits of having a medical card are free primary, community and hospital care. Stock image

Almost a third of individuals who are eligible for a medical card – about 400,000 people – are failing to take up their entitlement to access free GP services, medicines, hospital care and other benefits, according to new research.

A study by the Economic and Social Research Institute (ESRI) found such individuals are also spending on average almost €700 extra a year on healthcare and health insurance than those who have a medical card.

The ESRI research has estimated that 31% of almost 1.3m eligible people do not take up a medical card.

It found individuals who are self-employed, as well as those who are head of a household with higher educational qualifications, are less likely to claim their entitlement to a medical card than others.

The study also estimated that eligible families who do not take up a medical card are spending an additional €202 annually on healthcare along with an extra €489 on private health insurance compared to families who hold the card.

The ESRI said the amount was equivalent to 3% of their average annual income.

Medical cards, which are means-tested, confer free primary, community and hospital care on cardholders as well as prescription medicines with a small fee and other benefits including reduced rates of Universal Social Charge and exemptions from school transport charges and exam fees.

Weekly income limit

The current weekly income limit for single people living alone to claim a medical card is €184 for those aged under 66 and €201.50 for those aged 66-70 and €550 for anyone over 70.

ESRI researcher and co-author of the study Claire Keane said the findings showed the non-uptake of a medical card had significant negative financial implications for those affected.

“Given the scheme is aimed at families on lower incomes, this is particularly worrying,” said Dr Keane.

She added: “Negative effects of forgoing a medical card are likely to be even higher due to reduced medical care use, which may result in poorer health outcomes.” 

However, the study said the expansion of universal health care as proposed by Sláintecare – the Government’s 10-year programme to transform healthcare services – might help to resolve many of the issues relating to the non-take-up of medical cards by eligible persons.

Dr Keane said there were a variety of reasons to explain why eligible families were not availing of free medical cards, including the administrative burden of filing application forms and perceptions about how much benefit the card provided.

Stigma

She claimed other reasons might be stigma “as the card is aimed at those on lower incomes” as well as confusion about eligibility.

It found families with higher potential benefits from a medical card and families with more children as well as older people and adults who suffer from a chronic condition were more likely to take up their entitlement to a medical card.

Dr Keane said families with a high proportion of their income made up of social welfare benefits also had higher take-up rates.

She said there was evidence that people treat medical cards and private health insurance as substitutes for each other.

She added the research showed that being slightly over the medical card income threshold increased rates of private health insurance considerably.