Other areas within the health sector will be cut if significant savings cannot be made from the medical card review, the HSE has warned.
An information campaign was launched yesterday by the HSE in a bid to clear up confusion over who stands to lose their card.
The national director for primary care has again reiterated that those who have a genuine medical need will not lose their card - even if they are marginally over the income threshold.
John Hennessy said that there are a number of other ways to make savings under the review without having to remove cards.
"The vast majority of the savings realised by reviewing that number of cardholders are the numbers that don't wish to renew, or who have already left the area, or whose circumstances have changed substantially," he said.
"The number who are actually refused on means grounds is quite small.
"If we don't achieve that saving in relation to probity in medical cards, we simply have to go elsewhere for it and look elsewhere."