People who are terminally ill will no longer have to renew their medical card every six months under a new plan to go before Cabinet.
Currently, everyone - regardless of means - is entitled to a card if their doctor certifies they have a terminal illness.
But Health Minister Leo Varadkar said yesterday "it is quite cruel and upsetting" to compel them to renew it and he is looking at putting this off for three to five years or leaving it open-ended.
The proposal is among a series of measures overhauling the medical card system, the most controversial of which will be changes to assessing eligibility for a discretionary card.
The removal of so many discretionary cards, which are given to people and families over the income limit because of the financial burden of illness, led to a recent report by an expert group. The proposals aimed at easing difficulties on discretionary cards include introducing one application form covering regular medical cards, over-70s cards, the long-term illness scheme and GP visit cards.
It means if the applicant loses out on a full medical card they can be informed of other entitlements they can qualify for. A long-term illness scheme card allows people with certain illnesses free drugs and appliances, although they must pay to see their doctor.
A GP visit card allows free doctor visits, although drugs must be paid for.
There is evidence that separate applications meant people may have lost out on entitlements. Families who have a child with an illness which results in high bills may be granted a card after their case is assessed. But it would just be given to the child and not the entire family.
The system of assessment for a discretionary card may also be widened. It will still look at the income of the applicant but the criteria for judging financial hardship is expected to be more "generous" and still involve a medical panel who will look at individual needs.
All illnesses can be assessed for a discretionary card.
The proposals will be brought before the Cabinet sub-committee next week and the full Cabinet in the coming weeks, Mr Varadkar told 'The Pat Kenny Show' on Newstalk radio.
It is understood a proposal in the expert group report to take the responsibility of discretionary cards away from the HSE and give the assessment to the Department of Social Protection instead will not happen. The Department of Social Protection refused to take over the job.
Mr Varadkar said: "Under the current system you give the discretionary card to the entire family, whereas logically you would think you only give it to the child who is sick."
Meanwhile, new figures show that the numbers of discretionary cards issued have risen from 58,303 in September 2013 to 72,650 in the same month this year, a rise of 14,347.
All counties have seen an increase. Around 11,800 who lost a discretionary medical card or GP card between July 2011 and last June have had them returned after the Government tried to quell public protests.
The expert group report has also urged greater clarity for all citizens, regardless of medical card status, over access to therapies such as physiotherapy or occupational therapy. Free walking and other aids should also be automatic, it says.
The cost is still unclear.