Question
I run a small business and pay Class S PRSI. My wife
works part-time. Are we both entitled to medical benefits under the Treatment
Benefit Scheme?
Answer
Since 27 March 2017, the
Treatment Benefit Scheme has been extended to cover self-employed people who have
paid sufficient Class S PRSI contributions. The scheme is run by the Department
of Social Protection (DSP) and provides dental, optical and aural services to
qualified people. You should contact the DSP or your treatment provider to
check your eligibility before proceeding with any treatment. The number of PRSI
contributions required depends on your age.
Your wife may qualify in her
own right if she has enough contributions. If she doesn’t have enough, she may
still qualify for Treatment Benefit on your social insurance record. To do
this, you must qualify for Treatment Benefit and she must be dependent on you.
To be considered dependent she must:
·
Have a
gross income of €100 or less per week or
·
Earn more
than €100 per week and have been dependent on you before entering or resuming
insurable employment (at Class A, E, H, P or S) or
·
Not be getting
a social welfare payment (except Disablement Pension, Supplementary Welfare
Allowance, Carer’s Benefit or Child Benefit) or
·
Have a
Carer’s Allowance or State Pension (Non-Contributory) and have been dependent
on you immediately before getting this payment
Benefits under the scheme
include an annual oral examination by private dentists on a DSP panel. Most
dentists are on the panel so you shouldn’t have difficulty finding one. The
scheme also provides for a free eyesight test but does not include sight tests
for computer screens or driving licences. Half the cost of medically required contact
lenses and hearing aids, up to a maximum amount, may also be covered.
Opticians, optometrists or hearing aid suppliers providing the treatment or
hearing products must have a contract with the DSP.
You can get detailed information on the Treatment
Benefit Scheme on welfare.ie. Further
information is available from the
Citizens Information Service below.
Know Your Rights has
been compiled by Boyle Citizens Information Centre which provides a free
and confidential service to the public. Tel: 0761 07 6330
Address: Elphin Street,
Boyle, Co. Roscommon
Information is also
available online at citizensinformation.ie and from the Citizens Information
Phone Service - 0761 07 4000