Hundreds of thousands not taking up PRSI dental, optical benefits

Survey finds 725,000 eligible people have never made use of their entitlements

Department of Social Protection pays the full cost of a dental check-up once a year. Photograph: iStock

Department of Social Protection pays the full cost of a dental check-up once a year. Photograph: iStock

 

Hundreds of thousands of people are not taking advantage of a State benefit scheme offering free or discounted dental, optical and hearing care, new figures show.

Some 2.5 million people pay PRSI, which entitles them to services such as a free dental check-up once a year. However, more than two-thirds of those who qualify did not avail of the entitlement last year, while an even smaller number sought free eye and hearing exams and related equipment.

There were fewer than 805,000 applications for dental care under the scheme last year, while some 450,000 people took advantage of the optical scheme and about 15,000 availed of the hearing aid scheme.

In 2016 the then government reinstated the PRSI dental benefits cut during the recession and it also opened up the scheme to self-employed people and farmers who make certain contributions.

As well as a free annual check-up, the scheme covers a payment of €42 towards either a scale and polish (if it costs more, the balance paid by the patient is capped at €15) or clinically necessary periodontal treatment.

With PRSI optical benefits, eligible people can receive a free sight test and a voucher to the value of €42.37 towards new glasses. There is also a contribution available towards contact lenses, while repairs to glasses are also covered under the scheme. Benefits available under the medical appliance scheme include a payment of 50 per cent towards the cost of a hearing aid, up to a maximum payment of €500 per aid.

One of the reasons many people do not take advantage of the schemes is a lack of awareness, according to a survey to be published today. The survey from Specsavers suggests that just 7 per cent of the Irish adults who make PRSI contributions know the exact health entitlements available to them.

It found that a fifth of those surveyed were unaware of their eligibility for PRSI medical benefits, with a quarter of those unsure or unaware of what they themselves were entitled to under PRSI. It also found that 29 per cent of those had never made use of their PRSI entitlements, equivalent to 725,000 eligible people.

ALL YOU NEED TO KNOW

What is the treatment benefit scheme?
If you have paid PRSI, or are a dependant of someone who has paid PRSI, then you can get access to a limited range of dental, eye and ear care at either no cost or reduced cost.

But is it actually free?
It certainly can be. Under the scheme, the Department of Social Protection pays the full cost of a dental check-up once a year. And it makes a payment of €42 towards either a scale and polish or – if clinically necessary – periodontal treatment once a year.

Who offers the treatment?
Treatment is provided by private dentists on a State list. Most dentists are on the panel.

How do I know if I am eligible?
The dentist can check that once they have your PPS number as well as your date of birth and a signature.

What about the optical benefits?
That gets you a free eyesight test, once every second calendar year. However, sight tests for driving licences and other similar things are not covered under the scheme.

Anything else?
Yes you can get a payment once every second calendar year, towards either one pair each of reading and distance glasses, one pair of bifocals or varifocals or one pair of contact lenses (including disposables). If you need contact lenses on medical grounds, the department will pay half the cost up to a maximum of €500, provided you have a doctor’s recommendation.

So I can get really expensive designer glasses for nothing?
No. Basic frames are free. If you choose more expensive frames, the Department will pay €42 towards the overall cost and you pay the balance.

And what about hearing aids?
The department pays half the cost of a hearing aid, subject to a fixed maximum of €500 for each hearing aid, once every fourth calendar year. It also pays half the cost of repairs to aids, up to a maximum of €100, once every fourth calendar year.

How do I apply?
The good news is you don’t really have to do anything. The claims are made through your provider: dentist, optician, ophthalmologist or audiologist. They can check your entitlement in advance of treatment and claim the payment afterwards.