Farmers may now be eligible for health benefits
New legislation could save farmers – and their partners – money in eyesight, hearing and dental treatment, writes Martin O’Sullivan
MOST people will be aware that PRSI contributions (class S) made by the self-employed will entitle them to a contributory old age pension, widow’s pension or maternity benefit.
However, from March 27, 2017 the Treatment Benefit Scheme was extended to also cover self-employed people who pay Class S PRSI, which includes most if not all farmers.
The Treatment Benefit Scheme is a scheme run by the Department of Social Protection that provides dental, optical and aural (hearing aids) services to qualified people.
The scheme is available to people who have the required number of PRSI contributions.
Medical card holders are legally entitled to more extensive dental, ophthalmic and aural services from the HSE but, in practice, the availability of these services varies from area to area.
Individuals must have paid Class A, E, P, H or S social insurance contributions to be eligible.
The amount of social insurance you need depends on the person’s age. Any farmer who has been paying PRSI for five years or more will be eligible.
Farmers’ sons or daughters who have been in employment paying Class A PRSI may also be eligible, as will those sons or daughters who are in farm partnerships and who have made the necessary contributions.
Below is a table of the required number of contributions for people in different age categories:
SPOUSE, CIVIL PARTNER OR COHABITANT
A spouse, civil partner or cohabitant may qualify in their own right if they have enough social insurance contributions.
However, if they do not have enough social insurance contributions he/she may still qualify for Treatment Benefit on their spouse’s/partner’s social insurance record.
To qualify, the spouse, civil partner or cohabitant must be dependent on their spouse/ partner and be earning less than €100 per week.
If you were entitled to Treatment Benefit on your spouse’s, civil partner’s or cohabitant’s insurance record at the time of their death, you will continue to be entitled for as long as you remain widowed.
If you are working, you may qualify for Treatment Benefit on your own PRSI contribution record, provided you satisfy the PRSI qualifying conditions
Under this scheme, the Department pays the full cost of an oral examination once in a calendar year.
The examination is provided by private dentists who are on the Department of Social Protection’s panel, which includes most dentists.
In the case of a dependent spouse or civil partner, they should apply under the PPS number of the insured person.
The Treatment Benefit Scheme entitles eligible applicants to a free eyesight test. However, sight tests for computers, driver’s licences etc are not covered under the scheme.
The examination is provided by opticians who have a contract with the Department of Social Protection.
Where contact lenses are required on medical grounds on a doctor’s recommendation, the Department will pay half the cost, up to a maximum of €500.
This applies to a small num- ber of eye conditions that make wearing glasses impossible. Disposable lenses are not covered under the scheme. Contact lenses are not available on purely optical or cosmetic grounds.
The Department will pay up to half the cost of a hearing aid or repairs to a hearing aid, subject to a fixed maximum contribution of €500 for one aid and €1,000 if you need two aids.
Before you buy your hearing aid, you should make sure that you know the amount that you will need to pay on top of your grant. A list of hearing services companies can be found on www.welfare.ie.
The value of the hearing aid grant can be used if you qualify when buying hearing aids from the approved supplier.
Applications for dental services are made by completing a form D1 (form D2 for a dependent spouse, civil partner or cohabitant). Forms are available from the dentist.
Applications for optical services are made by completing a form O1 (form O2 for a depend- ent spouse, civil partner or cohabitant). Forms are available from the optician.
Applications for aural services are made by completing a form MA (form MA2 for a dependent spouse, civil partner or cohabitant). Forms are available from the suppliers.
Applications are made to the Treatment Benefit Section, Department of Employment Affairs and Social Protection, St Oliver Plunkett Road, Letterkenny, Co Donegal.
The Department of Social Protection will pay up to half the cost of a hearing aid