THOUSANDS of people face losing their medical cards under changes to the means test.
Health Minister James Reilly is targeting a €20m saving this year by tightening the rules on how much a person can earn before they lose their card.
This means that up to 18,000 people will have their cards taken away, based on the current average yearly cost of a medical card of €1,099.
According to figures supplied by the HSE, an average medical card holder gets around €280 in free GP fees and over €800 in free drugs each year.
The changes to the means test for the 1.8 million people on medical cards are part of the €750m in health service cuts which are on the way this year.
The Department of Health said that it would be tightening the rules on how much a person could spend and earn in consultation with the HSE.
It said that it could not estimate how many medical card holders would be affected until these "specific changes" were identified.
Medical card holders have their cards renewed on a yearly basis.
The changes to the means test are separate from the Budget reduction in the much more generous medical card income limits for pensioners aged over 70, which will see 20,000 of them lose their medical card and get a free GP card instead.
Under the current rules for people of working age, they can qualify for a medical card if they are earning less than €184 per week, or less than €266 in the case of a married couple.
These limits can be increased with an allowance of up to €39 per week for each child.
The weekly cost of travelling to work – either 30 cent per mile or the cost of public transport tickets – can also be added on.
And "reasonable expenses" for rent or mortgage payments and childcare costs can also be claimed.
But currently, there is no defined limit on these expenses.
Medical card holders are also allowed to have up to €36,000 in savings without affecting their claim.
The number of people with medical cards has soared during the recession, with more than 40pc of the population now in possession of one.
The higher rate of unemployment means that more people are qualifying.
The medical card entitles them to free GP visits and discounted prescription drugs – with a charge of €1.50 per item. The total cost last year of the medical card scheme was €1.4bn.
This includes 1.7 million people on medical cards and around 128,000 people on GP cards – who qualify for free GP visits but not free prescription drugs.
The HSE had been at the centre of controversy last year after complaints about long delays in processing medical card applications at its newly centralised national centre in Finglas in Dublin.
But the latest figures show that 95pc of applications are being processed within 15 days – ahead of the target in its service plan of 90pc.