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Cheaper drugs, free contraception, more dental care: How health benefits are improving

A recap of existing benefits and the new initiatives which may help you save some money this year

Once you qualify for the Treatment Benefit Scheme, you will also be entitled to a free eyesight test. Photograph: iStock
Once you qualify for the Treatment Benefit Scheme, you will also be entitled to a free eyesight test. Photograph: iStock

Free health benefits for taxpayers have been around some time, improving and then being cut back again, in line with the economy’s overall financial health.

Remember the outcry when dental benefits were slashed in the years of austerity following the financial crisis? They are still not fully restored but generally, in recent years, it has all been about enhancing the benefits available to taxpayers, with a number of new initiatives announced by Government of late.

So here’s a quick recap on existing benefits and the new initiatives which may help you save some money this year.

Remember, any expenses in excess of those outlined below — and provided they are not covered for by a private insurance policy — may be eligible for a tax rebate at 20 per cent of the cost.

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Free GP care

Since 2015, all children under the age of six — more than 400,000 of them — have been eligible for free GP visits. You just need a PPS number to qualify.

Now these kids are set to benefit from an extra two years of free GP care, as the scheme has just been extended to children aged six and seven. Not only that, but next year it is due to be rolled out to children aged eight and nine, while 2024 should see those aged 10, 11 and 12 also benefit.

Minister for Health Stephen Donnelly said recently that he wants the extension to six and seven year olds to be rolled out “as quickly as possible”, but there is no start date yet for the scheme.

At the other end of the age spectrum, anyone over the age of 70 is also entitled to a free GP card, although a medical card is only available for those who pass a means test (income of €550 per week for a single person and €1,050 for a couple).

Contraception

Women infamously once travelled by train to Belfast to buy contraceptives to protest against laws prohibiting their sale in Ireland but soon contraception, in addition to being widely available, will also be free in Ireland.

The initiative will mean that women aged 17-25 will be entitled to free contraception “as a first step toward providing free contraception to all”, Mr Donnelly has said.

The scheme will be delivered by GPs and Well Women centres, and is due to commence this August, although the Irish Medical Organisation recently indicated that negotiations on the issue are still in the “very early stages”.

It’s understood the scheme will cover most things contraception related, including the cost of two GP visits a year, the cost of the contraception and the cost of fitting and/or removal of various types of long-acting reversible contraception. The scheme is expected to cover most types of contraception, including injections, implants, the coil, the contraceptive patch and ring, and various forms of oral contraceptive pill.

A woman on the pill, for example, can typically expect to spend in excess of €200 a year for repeat prescriptions, plus GP visits.

The scheme is expected to cost the Exchequer between €20-€25 million a year.

Dental

One of the biggest bugbears of many parents is the cost of dental care in Ireland for children; yes the Health Service Executive does offer free services but its offering is so intermittent and difficult to qualify for, it doesn’t offer help to many.

However, the service has been expanded — just not yet for children.

Dental is one of the offerings available under the Treatment Benefit Scheme, which means that it is linked to PRSI contributions. So if you don’t pay PRSI — or haven’t paid enough of it — you likely won’t be eligible.

Most recently, the Department of Social Protection announced that people aged 25-28 can start to benefit from dental benefits provided they have been working for nine months. It is expected the move will benefit about 80,000 people. Previously, this cohort had to be in employment for five years (or make 260 PRSI contributions), so it is a significant improvement.

If you’re aged between 21-25 you may qualify if you have paid at least 39 contributions.

But what will the newly qualified cohort get? Once you qualify for the scheme, you’ll get a free annual check-up plus €42 towards either a scale or polish or, if clinically necessary, periodontal treatment once a year. This means that you should be charged no more than €15 for a scale or polish, as the cost of this has been capped.

However, you may instead opt to use it for a deeper clean with your hygienist, given that a typical hygiene visit will cost about €70, a check-up and teeth clean once a year will cost you about €28.

If you are self-employed, you have been entitled to such treatment benefits since 2017.

Cheaper drugs

Since March 1st, the cap on the drug payment scheme has been cut by 20 per cent, down from €100 to €80. The latest cut means that the scheme has been reduced by 44 per cent from €144 back in 2018. That means someone with a repeat prescription in excess of €144 is saving €64 a month, or €768 a year, so it’s a significant saving.

In addition to proof of ID, you just need your PPS number — and that of any relevant family members — to qualify for the scheme.

Eyes, ears and hair

Once you qualify for the Treatment Benefit Scheme, you will also be entitled to a free eyesight test, which would typically cost about €30, every two years. You will be entitled to a grant towards glasses or contact lenses.

This means that you can either pick your own glasses and get a payment of €42 from the department towards the cost of these, or pick basic glasses, which includes one pair each of reading and distance spectacles, one pair of bifocal or varifocals or one pair of contact lenses (including disposables).

Should you need contact lenses for medical reasons, then you might qualify for a payment of up to €500, provided your doctor has recommended it.

When it comes to hearing, a grant of up to €500 is available per hearing aid (with up to two aids eligible) every four years, while a grant for repairs, of up to €100 every year, is also available.

With hearing aids typically starting at about €500, depending on your choice or requirement, you might find that the scheme will cover the cost of your hearing aid.

Another recent enhancement to the scheme is the introduction of a new grant of up to €500 towards the cost of a hairpiece, wig or hair replacement. It has been available since last month.

Eligibility for the scheme is restricted to those whose hair loss is from a disease or treatment of a disease, such as cancer or alopecia, including the following types: alopecia areata; primary scarring alopecias; frontal fibrosing alopecia and lichen planopilaris; chemotherapy induced alopecia; alopecia resulting from surgery or trauma, including burns.

The average price of a wig in Ireland is about €350-€500, according to the Irish Cancer Society, with the cost increasing to €600-€1,000 for human hair.

Treatment abroad

Bear in mind that you are entitled to use your Treatment Benefit Scheme benefits in another European Union member state. This means that if you decide to get an eye test in France or buy a wig in Germany, you will get the same contribution towards this cost.

And if it turns out that the cost of the treatment is lower abroad, you may end up with no excess, as you will do in the case of many treatments in Ireland.

You can see the full amounts to be reimbursed here.

On the way

Free hospital charges

It’s not here yet but it’s expected that from next year public hospital inpatient and outpatient charges will be scrapped, meaning that regular hospital visitors stand to save significant sums.

At the moment you have to pay €80 for every night you spend in a public hospital, unless you have a medical card or private health insurance. This sum is capped at €800 a year.

As the first step in this, hospital charges for children — again levied at €80 a night — aged under 16 will be abolished this summer.

It’s unlikely, however, that the move will be extended to A&E and the €100 charge per visit is likely to stand.