Free examination with PRSI

iahavenoname

Hey all,

Just wondering is an examination covered by your PRSI? and if so how long do you have to be paying PRSI to avail of it

Thanks

lastlaugh

I don't think it's covered anymore. I've been paying PRSI for 10 years yet I still had to pay €40 for an examination recently.

I think something changed in January, last year I got an eye examination free through PRSI.

davo10

OP contact Dept of Social & Family Affairs in Letterkenny, ask for dental benefits section, give them your PPS number and they will tell you if you are qualified for dental benefit. If you are, you are entitled to one check up per year but make sure dental clinic participates in PRSI dental scheme. If you are not qaulified DSW will be able to tell you when you will be, it depends on the number and type of stamps you pay per year.

Unfortunately it does not cover any other treatment bar the check up, the Government butchered the scheme in October 09 budget.

lastlaugh

Just had a look here and it contains the below as davo10 said already...
It also lists your required contributions to be eligible for it.

Dental Benefit

Under this scheme, the Department pays the full cost of an oral examination once a year. The examination is provided by private dentists who are on a Department of Social Protection's panel. Lists of dentists on the panel are available in the Department's offices. Most dentists are on the panel so you should not have any difficulty finding one. The dentist or the Department will have the application forms. These forms require details such as your Personal Public Service Number (PPSN). If you are a dependent spouse or civil partner, you should give the PPSN of the insured person.

davo10, when I was going for the examination, they seemed to be checking my name on the system yet I was still charged the €40 for it. Would you know if I can claim that back?

DaveTwenty7

lastlaugh wrote: »

davo10, when I was going for the examination, they seemed to be checking my name on the system yet I was still charged the €40 for it. Would you know if I can claim that back?

You can't claim back off the government I'm afraid.
If your employment status has not changed you should contact the dentist to see if they still participate in the scheme, if they do ask why you were charged if you only had e an examination? If you had a clean that is no longer covered and where I work we charge €40 for a scale and polish (clean)

lastlaugh

DaveTwenty7 wrote: »

You can't claim back off the government I'm afraid.
If your employment status has not changed you should contact the dentist to see if they still participate in the scheme, if they do ask why you were charged if you only had e an examination? If you had a clean that is no longer covered and where I work we charge €40 for a scale and polish (clean)

Damn them!

Yes I only had an examination, which was 2 minutes involving the dentist checking all the teeth and telling his assistant what was needed.

I'll ask them if they participate in the scheme and why I was charged so.
Thanks.

davo10

LL, there are a couple of possible reasons as to why you were charged the €40.

1. When clinic contacted DSW to check your elegibility, they may have been told that you already had a check up on the PRSI within the last 12 months.
2. They may have been told that you are not qualified for dental benefit.
3. The charge for a new patient consultation may exceed the amount paid by the DSW (€26.40 net of 20% tax deducted at source by Government) and you may have had to pay the difference, this price must now be displyed in the waiting room.
4. Some clinics will not accept PRSI checkup payment as a standalone treatment as the cost of providing that appointment exceeds the amount paid by DSW. They will accept it if you are having a cleaning or filling etc as well. Even though I do accept PRSI for a check up alone, the cost of me providing it (ie running the clinic for that appointment) is over €40 so I make a loss of €14 on every PRSI checkup, but for me it is a loss leader as all treatments start with a check up.

No matter which one of these was the case, the clinic should have informed you and you are right to contact them for clarification.

lastlaugh

davo10 wrote: »

LL, there are a couple of possible reasons as to why you were charged the €40.

1. When clinic contacted DSW to check your elegibility, they may have been told that you already had a check up on the PRSI within the last 12 months.
2. They may have been told that you are not qualified for dental benefit.
3. The charge for a new patient consultation may exceed the amount paid by the DSW (€26.40 net of 20% tax deducted at source by Government) and you may have had to pay the difference, this price must now be displyed in the waiting room.
4. Some clinics will not accept PRSI checkup payment as a standalone treatment as the cost of providing that appointment exceeds the amount paid by DSW. They will accept it if you are having a cleaning or filling etc as well. Even though I do accept PRSI for a check up alone, the cost of me providing it (ie running the clinic for that appointment) is over €40 so I make a loss of €14 on every PRSI checkup, but for me it is a loss leader as all treatments start with a check up.

No matter which one of these was the case, the clinic should have informed you and you are right to contact them for clarification.

Thanks for getting back, unfortunately it was none of the above.

I rang the clinic earlier this morning and inquired about it.

They just rang back now and said that I was eligible for it and they would deduct the amount from the cost of my next filling, and I needed to fill out a form when I go in next.
I can also claim up to €40 per dental visit up to 12 times a year through VHI so things won't be as expensive as I had imagined.

Cheers.

davo10

Ah, they didnt think you were a PRSI patient or they would have asked you to sign a form when you had checkup, problem solved, well worth a phone call. Good luck.