When it comes to doctor’s visits, medicines and dentistry, you’re probably overpaying. The reason? Many of us don’t know what we should be getting for free or what we can claim back.
Some of us are not availing of schemes that can reduce our spend in pharmacies. Others may be delaying GP or dentist visits because of the cost, or not claiming back the average annual tax refund of €365 owed for medical expenses.
The age for free contraception has been revised up this year too, and free HRT is mooted. Here’s a run down of what you can save on health expenses.
Good medicine
Have you registered for the Drugs Payment Scheme (DPS)? Whether you have a regular monthly prescription or you or your household run into a high monthly pharmacy spend one or twice a year, it pays to sign up.
With flu season kicking off, spending on medicines is more likely to spike. Signing up to this scheme means you will get prescription medicines over a certain monthly threshold for free. The scheme is open to everyone, regardless of income.
“Everyone should register,” says community pharmacy owner David Dodd. “It means you will never have to pay more than €80 a month for [prescription] medicines.”
The DPS generally benefits those getting regular prescriptions most, but unexpected medical issues, or planned treatments like IVF, can easily tip households into spending more than €80 on prescription medicines in any month, so it is no harm to have it in place.
“It’s a great scheme because the €80 is per household, and that means that no family has to pay more than €80 a month for all their medication, and that’s irrespective of your means,” says Dodd. That figure has come down quite dramatically in recent years. Before 2018, you needed to spend more than €144 a month to benefit.
If you are applying as a family, the family can comprise an adult, their partner and any children or dependants. Children are defined as any young person in full-time education up to the age of 23. After that, they will need to apply for the DPS card on their own account.
If you already have a medical card, you don’t need a DPS card.
You’ll receive a card for each family member, to be presented at the pharmacy before a prescription can be dispensed. In most cases, the card only needs to be presented once, as pharmacies often retain the relevant details.
“There is no claiming needed,” says Dodd. “If you buy prescription medicines over the course of a month, once you hit the €80 threshold, the remainder of the medicines are free.”
“It’s advisable for a patient to obtain all their dispensed prescriptions from one pharmacy in any given calendar month to avoid having to pay more than €80,” says an Irish Pharmacy Union spokesman. This way, the pharmacist will know when you have reached the €80 threshold and won’t charge you more than that, says Dodd.
“It’s one rationale to stay with the same pharmacy because it’s easier for you to know how much you are spending,” he says. It also means you won’t have to faff about with receipts to claim back.
If you have a DPS card and do end up spending more than €80, perhaps because you used more than the one pharmacy, you can claim a refund from the HSE. The refund will be paid at the price the HSE paid the pharmacy. The pharmacy, however, may have charged you more.
Medical receipts
GP visits, prescriptions, orthodontic and certain other dental procedures, laser eye treatment, IVF, acupuncture, maternity care, psychologist and psychotherapist fees, speech and language therapy, nursing home fees and certain food products for coeliacs and/or diabetics – did you know you can get a tax refund on these?
Irish taxpayers are getting better at claiming back the hundreds of thousands owed to them for common medical expenses. Indeed, health expenses are the most popular expenses claimed back, Revenue figures show. Almost 90,000 claims were made by taxpayers for medical expenses in income tax returns for 2023.
The average refund for the 2022 year of assessment, for example, was €365. That’s a lot of money to leave unclaimed.
You can also claim back tax on diagnostic procedures, physiotherapy, chiropody or podiatry, treatment for squints, home nursing, hearing aids, diabetic glucometer.
The first tip to claiming is to keep your receipts. Taxpayers get 20 per cent back on costs you paid for yourself or another person. Relief on nursing home expenses is available at your highest rate of income tax.
You have four years from the end of a tax year to claim any relevant refunds. So, if you have any claims outstanding for 2020, you want to get moving as they will be statute barred from the start of next year.
Until relatively recently, expenses were claimed by filling out a special Med1 form. But now all taxpayers can claim relief for health expenses after the end of the relevant tax year by filing an income tax return. PAYE workers and pensioners can do this using Revenue’s MyAccount service, while self-assessed taxpayers will use ROS.
You can claim other tax credits, such as the rent tax credit, mortgage interest tax credit or remote working relief this way too.
Just upload a readable image of your medical receipts using the ‘Receipts Tracker’ service – that way you don’t have to retain the receipts for six years as you have to otherwise. If you are due a refund, you’ll receive it into your bank account in days.
PAYE taxpayers and those in receipt of a pension can alternatively make a claim any time during the year using the Real Time Credit facility in MyAccount. Again, you upload images of receipts. You’ll see any refund of tax due in your payroll.
If you have private health insurance, you can only claim tax relief back on the portion of the expenses you have not already been refunded through your insurance policy.
Coeliacs claiming for gluten-free food, or those claiming for diabetic products must get a letter from a doctor stating that you have coeliac disease or diabetes and keep receipts from supermarkets or chemists.
Free contraception?
The upper age threshold for the Free Contraception Scheme increased to 35 in July this year. That means if you or a loved one is aged between 17 and 35, you can now avail of free contraception to prevent pregnancy and treat other health issues.
For those on the contraceptive pill, this is a saving of about €70 for a GP consultation and €10 a month at the pharmacy. The scheme also includes emergency contraception.
Cost is certainly a barrier to some of the most effective forms of contraception, health professionals say. Before July, a 30-year-old woman for example would have had to pay over €500 for some long-acting reversible contraception (LARC) such as the coil.
This comprised €70 for an initial GP consultation, about €140 for the device from a pharmacy and another €250 to have it fitted. Its removal cost €55. Women aged 26 to 35 can now get this for free.
“LARCs are the most effective form of contraception, being 99 per cent effective in preventing pregnancy. But before the scheme launched, the upfront cost for the first consultation, the cost of the device and the second fitting appointment was often a barrier, particularly to younger women,” says Alison Begas, chief executive of the Dublin Well Woman Centre. “The scheme has been a wonderful and a very positive development in women’s health.
“Our three clinics have seen strong levels of demand for appointments within the free contraception scheme,” says Begas.
Early medical abortion, provided by a number of participating GPs and the Dublin Well Woman Centre and family planning clinics is also free. There is no age restriction, but the patient must be under nine weeks’ gestation to avail of early medical abortion in primary care, says Begas.
Those at between nine and 12 weeks’ gestation will receive an initial consultation under the scheme and will then be referred to one of the maternity hospitals.
A vasectomy, a surgical procedure providing permanent contraception, costs about €550. It is free to medical card holders, who may face waiting times and practice fees. Tubal ligation or female sterilisation permanently prevents pregnancy. It costs up to €1,500 privately with waiting lists for the public system.
Free HRT?
Plans for “free HRT” from January 2025 were announced in the Budget. The measure could save women between €360 and €840 a year based on current monthly payments. Legislation is expected to pass the Oireachtas in the coming weeks. That may not mean free HRT from January though.
“It’s great to say, oh they [HRT products] will be free, but in actual fact we can’t get them, so it’s a bit of a nonsense,” says pharmacist David Dodd.
“We are aware of one patient who had to phone up to 25 different pharmacies trying to track down the particular form of HRT she was taking, so supply will have to be addressed before the scheme goes live,” says Alison Begas.
Before a single free patch or gel is dispensed, pharmacists need to be on board too. The Irish Pharmacy Union says it is “actively pursuing a follow-up meeting” with the Department of Health to discuss how the scheme can work.
“If you look at the fine print, they have only said they will cover the cost of the drug, but not the dispensing fee. With the free contraception scheme, [the Government] pays the dispensing fee and the cost of the drug.
“The [HRT] patient will have to pay a dispensing fee if the pharmacy agrees to implement this,” says Dodd. This could amount to about €7.50 per item.
Dentistry
Cost can be one reason people avoid dentists. There is some free stuff to be had though. Those with enough PRSI contributions can get one check-up a year, including a scale and polish for which they will pay €15.
“Many patients are not aware of this PRSI entitlement,” says a spokeswoman for dental practice chain TrulyDental.
Your clinic can check if you have enough contributions using your PPS number and date of birth. To qualify, you will need to have made 39 weekly PRSI payments two years before the year of your dental appointment. So, if you are booking an appointment for this month, it will be your 2022 PRSI record that counts.
And if you need work done, you can claim 20 per cent tax back from Revenue on some “non-routine” dental care. This includes crowns, veneers, root canal treatment, periodontal treatment for gum disease, orthodontic treatment like braces, surgical extraction of wisdom teeth and bridgework. But it does not include fillings, for instance.
Your dentist will give you a Med2 form outlining your treatment and costs.
“I’d say only approximately 50 per cent of people are fully aware that they can claim back through Revenue,” according to the TrulyDental spokeswoman.
You can claim for non-routine dental treatment performed outside Ireland too. The dentist must be a qualified dentistry practitioner under that country’s laws and you must get them to complete a Med 2 form.
To claim, use Revenue’s MyAccount or ROS services and include the amount in your health expenses claim under the “non-routine” heading. You don’t need to send the Med2 form with the claim, but keep it, as Revenue may ask you to provide it.
