medical card - when do reviews happen

[taxpayer]

Hi
I have a question on how often reviews of circumstances happen in relation to medical cards.

Take a married couple both in full time employment in the public sector. They have 1 child and a mortgage.

The woman takes extended maternity leave and also 1 years career break from her job and is due to return to full time employment in september. She has been unpaid for the last year but has been living off her husbands income which is substantial.

She recently applied for a medical card and got it. This also entitles her to reduced childcare costs.

Can she avail of the medical card entitlements while back in full time employment? Or how often does a review of circumstances take place? If its every 2 years, then this couple can avail of the medical card benefits while both in full time employment for the next 2 years?

If this is the case then is it any wonder this country has gone to the dogs.

 

[gipimann]

From hse.ie FAQ on medical cards:

The card is usually issued for one year after which it is reviewed. Depending on your circumstances it may be issued for a longer period. If your circumstances change, you must inform the HSE as you may no longer be eligible. For example, if your income or family circumstances change, you must inform the medical card section at your Local Health Office as soon as possible.

It is up to the person concerned to notify the HSE of the change in circumstances (in this case returning to work).

Being in full-time employment does not bar people from applying for and receiving medical cards. There are income guidelines, with allowances for rent/mortgage expenditure and travel to/from work.

 

[taxpayer]

hi,

so the onus is on the applicant regardless of what their combined salary is? There doesnt seem to be any link between paye and social welfare.

said couple will most likely be on a combined income of 80k come september and yet they can avail of the medical card and reduced childcare costs until the next review which is 1 or 2 years down the line? because they have no intention of informing the hse when wife goes back to full time work in september.

makes me wonder why I work at all.

 

[browtal]

Hi Taxpayer,
Many people are thinking like you.
Currently people aged over 70 yrs and with income under €700 for one and €1400, for 2 people per week, are entitled to a medical card.
The original entitlement was anyone over 70 yrs regardless of their income were entitled to a medical card. This was withdrawn a few years ago and was replaced by the €700 per week income limit.

An announcement was made that people over 70 yrs who no longer qualified due to the new income limit should return their medical card. I wonder how many did?
Also another anomaly in this system, If one partner is over 70yrs and the other party is under, no age limit, they both automatically qualify subject to the income limit. Why does the normal income limit not apply to the under 70 yr old?
Our systems must at least try to be more just, there will always be abuse.
I also think an income of €700 per week is far to high to be entitled to a medical card.
Browtal

 

[Mrs Vimes]

hi,

so the onus is on the applicant regardless of what their combined salary is? There doesnt seem to be any link between paye and social welfare.

said couple will most likely be on a combined income of 80k come september and yet they can avail of the medical card and reduced childcare costs until the next review which is 1 or 2 years down the line? because they have no intention of informing the hse when wife goes back to full time work in september.

makes me wonder why I work at all.

Couple of points here:

1. you could paraphrase your concern as "My friend is planning to defraud Social Welfare and Revenue and I don't think he'll get caught". This is not one of the anomaly situations where a person is better off not working - this is fraud, pure and simple.

2. It's not so much that there is no link between Revenue and social welfare as that Revenue don't actually run all the payroll in the country - they have no real idea what a person is earning until after year end. The onus is on the taxpayer to ensure that they are paying the correct amount of tax and that they are not claiming any welfare they are not entitled to. Of course this remains the taxpayer's responsibility regardless of how much they are earning. How could it be otherwise?

3. I don't know what reduced childcare costs you are referring to?

I also agree that the threshold for over 70's medical cards is set ridiculously high - perhaps there should be a system where those with very high medical costs (people in the age group tend to have higher medical costs even than those with young children) could be subsidised once their costs hit a certain level?

Sybil

 

[taxpayer]

Hi,
in answer to the points you made

1. you could paraphrase your concern as "My friend is planning to defraud Social Welfare and Revenue and I don't think he'll get caught". This is not one of the anomaly situations where a person is better off not working - this is fraud, pure and simple.

of course it is fraud. I am just amazed that they can do this. That is why I asked the question as couldnt believe it at first. They will save themselves a considerable amount of money between medical bills and childcare costs. and all the while in fulltime employment in the public sector - so they have job security.

2. It's not so much that there is no link between Revenue and social welfare as that Revenue don't actually run all the payroll in the country - they have no real idea what a person is earning until after year end. The onus is on the taxpayer to ensure that they are paying the correct amount of tax and that they are not claiming any welfare they are not entitled to. Of course this remains the taxpayer's responsibility regardless of how much they are earning. How could it be otherwise?

every soul in this country has a pps number. how hard could it be to do a check?

3. I don't know what reduced childcare costs you are referring to?

according to said couple, a hse creche will only charge a portion of full fees to all medical card holders. I have my own child in a hse creche but wasent aware of this fact as I dont have a medical card and am paying the full amount.

I also agree that the threshold for over 70's medical cards is set ridiculously high - perhaps there should be a system where those with very high medical costs (people in the age group tend to have higher medical costs even than those with young children) could be subsidised once their costs hit a certain level?

this is also in relation to previous posts. My issue isnt with over 70's right or not to a medical card. Or even under 70's. I just cant understand how a married couple both in fulltime employment can get a medical card.

My point is that as a paye worker myself (in the private sector) paying out left right and centre for everything (creche,doctors,mortgage etc) and with myself and my partner taxed to the hilt, i find it hard to stomach another couple in a similar situation can avail of a loophole in the system.

 

[Mrs Vimes]

every soul in this country has a pps number. how hard could it be to do a check?

As I said, Revenue don't run payroll. They could call up every employer in the country and ask them what so-and-so earned last week, but that would be impractical. All Revenue get during the year is a monthly return from each employer paying over the total PAYE/PRSI/USC for the firm. They don't get a breakdown of how much each employee was actually paid until the P35 is submitted in February.

according to said couple, a hse creche will only charge a portion of full fees to all medical card holders. I have my own child in a hse creche but wasent aware of this fact as I dont have a medical card and am paying the full amount.

I didn't know about that.

this is also in relation to previous posts. My issue isnt with over 70's right or not to a medical card. Or even under 70's. I just cant understand how a married couple both in fulltime employment can get a medical card.

A couple with a few kids both in low-paid jobs would qualify and rightly so in my opinion. I realise that that is not the case with your friends.

y point is that as a paye worker myself (in the private sector) paying out left right and centre for everything (creche,doctors,mortgage etc) and with myself and my partner taxed to the hilt, i find it hard to stomach another couple in a similar situation can avail of a loophole in the system.

Equally, you could fake up some payslips and make a bogus claim for a medical card and the system can do very little to counter-act that. I'm guessing you wouldn't because a) you're not a cheat and/or b) you would probably eventually get caught. The fact that it's possible and probably happens doesn't make it a loophole (An ambiguity or inadequacy in the law or a set of rules).


I do understand that you are disgusted that this can happen but it is the fault of your fraudster friends and not a system which is forced by practical necessity to rely to an extent on honesty. They may well get caught eventually. If I was you I would probably be very tempted to grass them up.

 

[taxpayer]

Hi

I couldnt live with myself if I grassed them up. Its just not me. However, said couple wont be on my christmas list.

Anyway I am more furious with a system that is based on the honesty the applicant. Is every application for a medical card treated as a truthful application ? Or is it a case that the system is so stressed that there is no will to make an attempt at some background checking?

What would the IMF make of this? Im sure its only one small issue in a litany of issues within social welfare.

I and every other taxpayer is paying for this afterall.

 

[Mrmr]

I applied for and received one on Maternity, however it was only issued for 6 months and I had to supply plenty of documentation.

At the end of the 6 month period I had to re-apply. I would have hoped they were running this system for all 'between-jobs' scenarios as it makes good sense.

 

[taxpayer]

Hi

it only makes good sense if the applicant is at the recommended threshold to qualify for a medical card.

Getting a medical card in July then returning to secure full time employment 2 months later in september isnt right or fair. also while spouse is already in secure full time employment.

even if the review isnt till 6 months, and I have been told 2 years, how is it fair or "good sense" that this person should benefit from free medical care and reduced childcare costs all at the expense of the taxpayer? And also while both wife & husband are in secure full time employment?

 

[Mrmr]

I'm not sure why you seem to be getting frustrated with me.
My point was that it makes good sense to have a shorter re-qualification period for situations where a person is between jobs, or on maternity leave etc.

That is my point, and that I would have hoped they would be using shorter audit periods across the board for situations like this in order to catch people who do not qualify due to a change in circumstances after a few months.

 

[serotoninsid]

My med. card was due to run out in October. I was surprised when I got it previously (2 years ago) - but must have just squeezed in under the threshold. I assumed that things would have gotten more difficult - and that if I was borderline before, would be challenging to qualify for it this time. However, on Monday, a brand new spanking card arrived in the post. I had not re-applied? I thought this would have been a requirement?

Anyways - in no way complaining - but very surprised....