Agreement finally reached on high earners

Last week's successful ballot of the approximately 800 members of the Irish Dental Association now means that the income limit which had denied PRSI contributors earning in excess of £35,000 access to Department of Social Welfare dental benefits, as well as civil and public servants who joined the service since 1995, is well and truly gone. The limit was officially abolished when it was announced in the Minister for Finance's Budget speech last January, but the compensation package to the dentists was only agreed last week. Between April, when the Budget changes were to come into effect and last week, claims from PRSI contributors earning over £35,000 were disallowed.

Yet despite the long-awaited agreement, higher earners will still end up paying more. As part of their compensation package to the dentists, the Department of Social Welfare has agreed that, as before, anyone earning up to £35,000 with the appropriate number of PRSI contributions, and their dependant spouses, will be eligible for a range of treatment benefits under the benefits scheme.

Preventative treatments, such as oral examinations, teeth cleaning and polishing will be paid entirely by the Department; other treatments such as x-rays, fillings, extractions and dentures will be paid by the Department and patient either on a 70/30 or 50/50 specified cost basis.

Finally, there are certain treatments, such as root canal work towards which the Department pays a set amount as a subsidy, also called a "grant-in-aid". The overall cost is set by the individual dentist.

With the exception of preventative care, the PRSI contributor earning more than £35,000, and their dependent spouse will now be obliged to pay for all the listed treatments strictly on a "grant-in-aid" basis.

The set £13.80 the Department pays towards an extraction, for example, will for this group be considered the grant-in-aid payment and not the 70 per cent subsidy. Instead of only paying £5.90 as the balance of the total extraction cost, the £35,000 plus earning patient will have to pay whatever balance payment is set by the dentist. This might be £5.90 or it might be £15.90. The impact of this "grant-in-aid" change will have an impact on the dependent spouse of the PRSI contributor.

In 1992, when the £35,000 income limit for Dental Scheme benefit was imposed, it was agreed that the dependent spouses of such PRSI contributors should not be deprived of treatment. It was seen as unfair that a couple, both earning £34,999 could qualify for treatment while a couple with a combined income of £35,000 but only one spouse earning, could not. It was therefore agreed that a dependent spouse of a PRSI contributor earning up to £70,000 could receive treatment benefits under the Department of Social Welfare scheme.

Now, even though both the higher earning PRSI contributor and the dependent spouse are both eligible for treatment benefits under the revised scheme, payment will be on a mainly grant-in-aid basis and therefore at a potentially significantly higher cost to the dependent spouse than previously.