Thursday 22 August 2019

How to save thousands on your medical bills with State digouts

As some axed benefits are restored, you can cut health costs by taking advantage of Government schemes and tax breaks, writes Louise McBride

From this January, the cost of buying prescribed drugs or medicine under the Drug Payment Scheme will be no more than €134 a month - as the monthly cap was cut in the recent Budget. Stock image
From this January, the cost of buying prescribed drugs or medicine under the Drug Payment Scheme will be no more than €134 a month - as the monthly cap was cut in the recent Budget. Stock image
Louise McBride

Louise McBride

In the first two years of my eldest daughter's life, she could only drink a prescribed milk formula - due to a digestive intolerance to dairy. Without that milk, she would have broken out in severe eczema. The bill for that formula would have run into hundreds of euro each month were it not for a Government scheme which capped the monthly cost at €90 initially, and €100 after that.

That scheme, the Drug Payments Scheme, is still in place. However, the monthly cap has been increased since and it now stands at €144.

From this January, the cost of buying prescribed drugs or medicine under the Drug Payment Scheme will be no more than €134 a month - as the monthly cap was cut in the recent Budget. Many will argue that the cap should be reduced further and that the new limit of €134 a month doesn't go far enough in reducing the financial hardship faced by those who continually face high medical bills.

I was lucky to be able to use the scheme when the cap was set at €90. Thankfully my daughter no longer needs the formula. However, without the scheme, the cost would have been considerably higher than it was and taken a sizeable chunk out of my take-home pay.

For anyone who consistently needs expensive medication, the Drug Payment Scheme can help curtail what might otherwise be runaway medical bills. It is aimed at individuals and families who don't have a medical card and who normally have to pay the full cost of their medication. It is one of the supports available from the State which can help to drive down medical bills. Here are some others worth knowing about.

PRSI Benefits

Since the October bank holiday weekend, it has been possible to get a free scale and polish at your dentist, and free glasses at your optician's - as long as you have paid enough PRSI.

This is due to recent changes to the State's Treatment Benefit Scheme, which provides cover for certain dental, eyesight and hearing care.

Several benefits available under the scheme were cut during the recession.

However, under Budget 2017, the Government started to reinstate some of the benefits that had been chopped. So since October 28, the scheme covers the full cost of a dental scale and polish once a year - as long as the treatment costs no more than €42. Otherwise, you must pay the balance (up to a maximum of €15 extra). The scheme also covers up to €42 of the cost of more extensive periodontal treatment once a year, if clinically required. These recently restored dental benefits are in addition to the free annual dental check up (which was brought back last March).

The scheme also now covers the cost of a pair of reading, distance, bifocal or varifocal glasses once every two years - though you may still need to pay something towards the cost of the glasses, depending on the frames you choose. Basic frames are free but if you choose more expensive frames, the scheme pays €42 towards the cost, and you pay the balance. Repairs to glasses are also covered under the scheme, though you will need to pay a contribution towards the cost if your frames are more expensive than the basic ones.

Should you prefer contact lenses to glasses, you can get €42 towards the cost of a pair of ordinary contact lenses once every two years.

You can also get a free eyesight test once every two years, though sight tests for driving licences and computer screens are not covered.

Should you need contact lenses on medical grounds, the scheme covers half the cost of the lenses - up to a maximum of €500 and as long as you have a doctor's recommendation. Cover for medical lenses is available once every four years.

"The lenses referred to [for the €500 cover] are provided for medical reasons - that is, a person may have an eye condition that requires that they wear special contact lenses to treat or correct a condition, or where they cannot wear glasses for medical reasons," said a spokeswoman for the Department of Employment Affairs and Social Protection (DEASP).

The scheme covers those who wear hearing aids for half the cost of an aid (up to a maximum of €500 per aid). This cover is available for two aids - once every four years.

Both employees and the self-employed are eligible for benefits under the Treatment Benefit scheme - as long as they have paid a certain type and amount of PRSI. The number of PRSI contributions that must have been paid varies, depending on your age. You may also have had to pay some of those contributions at a particular time. For example, an individual under the age of 21 may qualify if they have paid at least 39 PRSI contributions at any time. However, for most other individuals, these 39 PRSI contributions must have been paid two years before the year that a benefit is being claimed under the scheme. "The relevant tax year for Treatment Benefit in 2018 will be 2016," said a spokeswoman for the DEASP. Those aged between 25 and 65 must usually also have paid at least 260 PRSI contributions to qualify for the benefits.

Medical tax relief

You can claim back a fifth of the cost of certain medical bills in tax relief. This tax relief could therefore be worth hundreds, if not thousands, depending on how high your medical bills are.

Tax relief can be claimed on a range of medical expenses, including doctor and consultant bills, drug prescriptions, IVF, and the cost of certain food products if you have specific dietary requirements due to a medical condition.

A number of dental bills, such as root canal treatment and crowns, also qualify for relief. You cannot however claim tax relief on routine dental treatment, such as fillings and tooth extractions (unless it's for surgical extraction of impacted wisdom teeth).

Similarly, there are a range of medical expenses, such as cosmetic surgery (unless required to correct a health issue), which don't qualify for relief. Tax relief on nursing home expenses is an even more valuable tax break as you could claim as much as 40pc of nursing home bills back in tax.

Insurance tax break

The annual cost of private health insurance can run into the thousands. The tax break on private health insurance, which allows you to claim back a fifth of the cost of a policy, is therefore a valuable one. This tax relief is calculated by your insurer, which then automatically reduces the cost of your policy by the amount of relief you're entitled to. Since mid-October 2013, it has only been possible to claim the full tax relief on policies which cost no more than €1,000 per adult and €500 per child. For this reason, it is best to choose policies which cost no more than the limits set for the purposes of tax relief.

Free GP care

Since 2015, GP visits have been free for all those over 70 and all children under the age of 6. The Government is planning to extend free GP care to all children under the age of 12.

We're in for a wait though. "The Health Minister's wish is that progress on the extension of free GP care to children under 12 can be made in 2018," said a Department of Health spokesman. "However, the timetable will be subject to the outcome of discussions with GP representatives on this and other contractual matters currently being discussed."

In the meantime, it will either cost you nothing to bring your child to the GP during normal hours - or around €50 or €60, depending on the age of your child.

Useful resources

This is an overview of the benefits available under the Treatment Benefit scheme — and who is eligible for them. One of the conditions which those aged between 25 and 65 must meet to qualify for the scheme is the payment of at least 260 PRSI contributions. This means that you must typically be working for at least five years to be covered. “Students and people aged under 21 may qualify if they have paid at least 39 contributions at any time,” said the DEASP spokeswoman. “A person can only qualify for Treatment Benefit if they personally have paid PRSI — or if they meet the criteria for dependent spouse, civil partner or cohabitant.” So if you’re married and don’t have enough of your own social insurance contributions to qualify for Treatment Benefit, you may still be eligible if your spouse has enough contributions — as long as you’re financially dependent on your spouse.

This provides information on the Drugs Payment Scheme, which restricts the amount you must pay on prescribed drugs or medicine to €144 a month — or €134 a month from January 2018. Here you will find information on whether or not you’re eligible for the scheme, how to join it, and how to apply for a refund.

This includes advice from the Revenue Commissioners on the tax relief available on health expenses, including medical, dental and nursing home expenses. Tax relief on nursing home expenses is granted at your higher rate of income tax so if you are a higher rate taxpayer and paying the bills on behalf of an elderly relative, you should qualify for 40pc relief.

This document is a very detailed account of the various health expenses which qualify for tax relief. It is worth checking to make sure that a health expense which you are planning to claim tax relief on is eligible for the relief.

This is the Med1 Form — the form used to claim tax relief on health expenses (if you are not claiming them online).

This link outlines how to apply for a GP Visit card if your child is under six — and it also has a list of the GPs who have signed up to the scheme.

This link provides information on the VAT refunds available on certain special aids and appliances used by those with disabilities.

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