The Minister for Social Affairs, Séamus Brennan
T.D., today (Sunday, 5th June) announced that his Department's Treatment Benefits Scheme, which provides a range of dental and optical benefits and supports, will in future offer the additional choice to qualifying customers of having the treatment carried out in any of the other EU Member States.
The Scheme, which is based on PRSI contributions, last year, benefited over 700,000 people at a cost of more than €60 million, covers Dental Benefit, Optical Benefit, contact lenses and hearing aids.
Minister Brennan said he had signed regulations bringing the choice of having treatment in any EU Member State into immediate legal effect.
In the cases where people choose to have the treatment in another EU Member State, the Department of Social Affairs will pay an amount equivalent to the rate paid for treatments carried out in Ireland or the amount actually paid for the treatment, whichever is the lower.
Minister Brennan said: "The new regulations significantly expands the range of options that customers qualifying for the Treatment Benefits Scheme have on offer. I am delighted that the opportunity has now arisen to enhance what is a very popular and valued scheme by providing customers with qualifying contributions with the choice of having treatment in Ireland or in any other EU country and still receive benefit from my Department".
" Customers will now have the opportunity to shop around for the best available services and prices before deciding where they want the treatment carried out. The expansion of this scheme is further evidence of my Department’s commitment to use every opportunity to improve services for our customers".
Over 700,000 people benefited under the scheme in 2004 - an increase of over 20% on the previous year - at a cost of over €60 million. A breakdown shows that 523,676 claims were paid for dental treatment (cost €45.8m), 172,199 optical claims (€10.9m) and 5,749 audiological claims (€4.4m).
So far this year, over 223,000 people have received Dental Benefit, over 68,000 have received Optical Benefit and about 2,000 received payment towards contact lenses and hearing aids.
Treatment Benefit is provided, in Ireland, through a panel of practitioners who enter into agreements with the Department to provide treatments under the scheme on a contract basis and at specified fees. The Department pays its contribution directly to the practitioner, with the customer paying any remaining balance. Currently some 1,700 dentists, opticians and audiologists in Ireland have contracts with the Department and are paid monthly for operating the scheme.
For services received abroad under the new arrangements, the patient pays the practitioner in full, and afterwards sends the application form (completed by the dentist, optician or audiologist) to the Department. Payment is issued to the patient directly, rather than to the practitioner. Medical practices are thoroughly regulated by each country throughout the EU and the relevant qualifications are generally recognised under EU regulations.
Applicants should contact Treatment Benefit Section of the Department of Social Affairs at LoCall 1890 400 400 (ext 4480) or 01 704 3000 before travel, for an application form and details of the amounts the Department will pay.
Under the Treatment Benefit Schemes, Dental Benefit pays €57.90, currently the full cost, of dental examination and diagnosis, scaling and polishing (including mild gum treatment), and some of the cost of a range of different dental treatments including severe gum treatment, fillings, extractions, dentures and root canal therapy – e.g. it contributes €30.20 towards a filling. Qualified customers, receiving treatment in other EU Member States, will now be reimbursed these amounts or the actual cost of the treatment, whichever is the lower.
Treatments such as crowns, bridge work and implants are not covered by the scheme.
Optical Benefit pays some of the cost of optical treatments including eye examination, glasses, replacement lenses to existing frames and contact lenses – e.g. the Departments pays €40.83 towards the cost of spectacles.
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 €700 per aid.
The following are the
EU Member States,outside of Ireland, where Treatment Benefit can be availed of: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Luxembourg, Malta, Poland, Portugal, Republic of Cyprus (Cyprus South), Slovakia, Slovenia, Spain, Sweden, the Netherlands, the United Kingdom.
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