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When your Medical Card or GP Visit Card is reviewed, reduced or stopped

The HSE may review, reduce or stop your Medical Card or GP Visit Card if your circumstances change or if you no longer meet the rules.
You will always be told in writing what decision has been made and why.

This topic explains what usually happens, and how to ask for a reassessment or appeal if you think the decision is wrong.

Use this topic if you or someone you support wants to:
  • Understand why a Medical Card or GP Visit Card has been reviewed, reduced or stopped
  • Check a decision letter for mistakes or missing information
  • Ask the HSE for a reassessment of a means test or discretionary decision
  • Appeal a medical card decision to the HSE National Appeals Office
  • Make a complaint about the application or review process

Note

This page offers plain language guidance. It is not a legal document.
Only the Health Service Executive (HSE) can make an official decision about a Medical Card or GP Visit Card.

Before you begin

You do not need everything on this list, but these details can make things easier.

Try to have:

  • The decision or review letter from the HSE
  • Any review forms or supporting documents you recently sent in
  • Your PPS number, date of birth and Medical Card number if you know it
  • Recent information about your income, savings, rent or mortgage
  • Notes on your family circumstances, for example who lives with you and who depends on your card
  • Any medical reports or letters from your GP or hospital that support your case

Keep the envelope and reference numbers from HSE letters. These can help if you need to phone or write back.

Steps

Step 1. Understand why your card was reviewed or changed

Start by reading the HSE letter carefully. It should explain:

  • Whether the decision is about a Medical Card, a GP Visit Card, or both
  • If your card is being renewed, reduced to a GP Visit Card, or stopped
  • The reason for the decision, for example:
  • A means assessment shows income above the guidelines
  • A discretionary decision did not approve or renew the card
  • Changes in household, work or social welfare payments

Check whether the letter mentions:

  • A request for more information
  • An option to ask for a reassessment
  • Your right to appeal and where to send an appeal

If anything is unclear, you can:

  • Phone the Medical Card office listed on your letter, or
  • Bring the letter to a Citizens Information Centre and ask them to go through it with you

Understanding the reason will help you decide whether to supply extra information, ask for reassessment, or appeal.

Step 2. Check for mistakes or missing information

Before you ask for a reassessment or appeal, check whether the HSE had the full and correct information.

Go through your letter and any recent forms and ask:

  • Are your income and expenses correctly listed
  • Have they included all allowable deductions or costs you told them about
  • Have they correctly counted family members who depend on your card
  • Are your address and contact details up to date

If you spot a mistake or realise something important was not included, you can:

  1. Write a short note explaining what is wrong or missing
  2. Gather any supporting documents, for example updated income details, proof of rent or mortgage, or medical reports
  3. Include copies, not originals, unless the HSE specifically asks for originals

You can then decide whether to send these as part of a reassessment request or a full appeal.

Step 3. Ask the HSE for a reassessment

A reassessment is usually the first step if you believe the means assessment is incorrect or if you have new information that was not in your original application.

You can ask for a reassessment if, for example:

  • Your income or expenses were miscalculated
  • You now have extra information about medical costs, debts or caring responsibilities
  • Your circumstances have changed since you applied

To ask for a reassessment:

  1. Follow the instructions in your letter. There may be a contact address, phone number or email
  2. State clearly that you are asking for a reassessment of the means assessment
  3. Explain in plain language why you think the decision is wrong
  4. Attach copies of any new or corrected documents

The HSE will:

  • Review your file again, including the new information
  • Decide whether to change or uphold the original decision
  • Write to you with the outcome of the reassessment

If you still do not agree with the outcome, you can appeal.

Step 4. Appeal a medical card decision

If you are not satisfied after reassessment, or if your letter tells you that you can appeal directly, you can send an appeal to the HSE National Appeals Office.

An appeal is usually for decisions about:

  • Whether your income and expenses were properly assessed
  • Whether you should receive a Medical Card or GP Visit Card on a discretionary basis

To make an appeal, you usually need to:

  1. Write a letter explaining that you want to appeal a medical card decision
  2. Include:
    • Your name, address, PPS number and Medical Card number if you have it
    • A copy of the decision letter you are appealing
    • A clear explanation of why you disagree with the decision
    • Any supporting documents you have not already sent
  3. Send your appeal to the Appeals Office address shown in your letter or on the HSE website

The appeal will be considered by HSE staff who were not involved in assessing your original application. They will look at:

  • Whether your income and expenses have been properly assessed
  • Whether you fall into a category that may be exempt from the financial means test
  • Any medical or social factors that may support your case

You will receive a written decision on your appeal. This is usually the final decision on the application.

Step 5. Make a complaint about the process

Sometimes you may be concerned about how your application or review was handled, rather than the decision itself. For example, if:

  • There were long delays in processing your application
  • You found the communication unclear or upsetting
  • You believe staff did not follow the correct procedure

In these cases, you can:

  1. Contact the Medical Card complaints contact listed on the HSE website or in your leaflet
  2. Explain that you are making a complaint about the medical card application or review process
  3. Give your name, address, PPS number, and the dates of letters or phone calls
  4. Describe what happened and what you would like to see improved

A complaint is separate from an appeal. You can make a complaint as well as asking for a reassessment or appeal if this is appropriate.

What to do next

If you:

  • Have received a letter saying your card is reduced, changed or stopped, or
  • Are unsure whether to accept the decision or challenge it,

you can:

You do not have to go through this alone. Support workers, family members and Citizens Information staff can help you read the letters, prepare your documents and decide on your next step.