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DPS isn't capped at €134 it seems...

CtrlAltDelete

Perhaps this has been covered before and my apologies if so. However I searched and couldn't find it.

So, while we are lead to believe that the DPS has a monthly cap of €134 I recently discovered this isn't the case unless you use the same pharmacy.

Back in Oct I picked up my regular monthly prescription ( into my 5th year of €134 payments now ) on a Friday. In an unrelated medical incident I ended up at Westdoc on the bank holiday Monday and subsequently ended up in the pharmacy close by. My usual pharmacy is close to my work & 40 miles away. I had to pay for my prescription on the day & when I explained my circumstances the pharmacist gave me a form, told me to send off the receipt & I could claim the cost of the prescription since it was within the same month & I had already paid my €134 three days earlier.

Filled out the form, posted it off with the receipt & a few weeks later received a cheque from the HSE to the tune of 68% of the cost. I called them to ask why I hadn't received the full amount since I had already maxed my monthly payment & was told that it was the "pharmacists mark-up" & that was all I was entitled to. I made the point that if for example I ended up at 3 different pharmacies in a month for whatever reason then I would be exceeding the payment cap with no way to claim it back & I was told that is correct. So..

Has anyone else experience of this scenario ?

I spoke to my own pharmacist as I know him quite well and he said that he could not see why, and did not know of any reason or rule that states I was not entitled to be fully reimbursed. He said that the 'pharmacist mark-up ' in this scenario and for the particular drug I required wasn't applicable.

My own pharmacist also informed that he has a card scanner which he was issued with approx 15 years ago by the HSE when a universal system was to be put in place so that all the pharmacies were linked & everyone had a DPS card that could be scanned.. which makes total sense. Machine arrived... project shelved. He informed me that every pharmacy in the country at the time got one of the card reader machines. Typical Ireland.. money down the drain after someone got themselves a nice contract of providing the readers.

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CtrlAltDelete

[Deleted User] wrote: »

Ok. Haven't read the whole thread but got medication in several pharmacies about a year ago totalling over €134 in one month. Was informed that for the cap to be in effect at time of purchase everything had to be from the one pharmacy. Was directed to HSE refund form. Filled it in and posted it to Drug Refund Section - yes, a bit of an inconvenience but I survived. They refunded me a few weeks later for the excess over €134 that month.

And thereafter the issue didn't arise as I stayed with the one pharmacy.

Interesting. So this contradicts Locum-motions theory...

Avatar MIA

CtrlAltDelete wrote: »

Interesting. So this contradicts Locum-motions theory...

Not necessarily - THAT pharmacy may have sold at a margin in line with what the HSE purchases for that particular product.

The excerpt from the form I reproduced above indicates you may lose out if you don't use the same pharmacy.

duffman13

Graces7 wrote: »

Because of the distances and other obligations. Driving an extra 60 miles so you can get to the same pharmacy? Especially if you are unwell...

Go to the one you live nearest too? Would that not make the most sense when your using a scheme like DPS. I know some people tend to bring it to the pharmacy near their jobs etc but DPS should be used in your nearest pharmacy with the best accessibility IMO.

Granted if you live somewhere really rural this is difficult sometimes to find however DPS is a good scheme despite its flaws.

CtrlAltDelete

Avatar MIA wrote: »

Not necessarily - THAT pharmacy may have sold at a margin in line with what the HSE purchases for that particular product.

The excerpt from the form I reproduced above indicates you may lose out if you don't use the same pharmacy.

Fuaranach stated "several" pharmacies... So what's the likelihood that "several" pharmacies had the same margins ??

Avatar MIA

CtrlAltDelete wrote: »

Fuaranach stated "several" pharmacies... So what's the likelihood that "several" pharmacies had the same margins ??

Not clear, what's the point you're making, that the HSE singled you out and didn't refund you the excess (per policy) and did for Fuaranach?

duffman13

CtrlAltDelete wrote: »

Interesting. So this contradicts Locum-motions theory...

Some pharmacies don't charge a mark up at all and only charge a dispensing fee. Their is no hard and fast rule in the pharmacy industry in terms of either mark up or dispensing fees and it's extremely difficult at times to get an answer from pharmacies on this.

CtrlAltDelete

duffman13 wrote: »

Go to the one you live nearest too? Would that not make the most sense when your using a scheme like DPS. I know some people tend to bring it to the pharmacy near their jobs etc but DPS should be used in your nearest pharmacy with the best accessibility IMO.

Granted if you live somewhere really rural this is difficult sometimes to find however DPS is a good scheme despite its flaws.

Circumstances make the pharmacy closest to work the most accessable. If you read my original post you'll understand the situation I was in that lead to me starting this thread.

daheff

CtrlAltDelete wrote: »

It's not always possible for people living in the countryside....

Why not? Surely you go to the most convenient pharmacy to you?

Also, if you do have to go to another pharmacy than your regular one, show them the DPS card & get the DPS rates.

A lot of them have agreements in place that they will check with other pharmacy and you wont pay over the 134 EUR amount.

CtrlAltDelete

Avatar MIA wrote: »

Not clear, what's the point you're making, that the HSE singled you out and didn't refund you the excess (per policy) and did for Fuaranach?

Quite clear if you care to read through the ongoing discussion. Not stating that I was singled out at all. Flawed system with unclear guidelines for the public.

CtrlAltDelete

daheff wrote: »

Why not? Surely you go to the most convenient pharmacy to you?

Also, if you do have to go to another pharmacy than your regular one, show them the DPS card & get the DPS rates.

A lot of them have agreements in place that they will check with other pharmacy and you wont pay over the 134 EUR amount.

Consider reading the OP and subsequent replies.

Avatar MIA

CtrlAltDelete wrote: »

Quite clear if you care to read through the ongoing discussion. Not stating that I was singled out at all. Flawed system with unclear guidelines for the public.

I am following, fascinated.

How was your last post re Locum to do with a flawed system?

The only thing "flawed" about it is that it's not as convenient as desired. If they brought in a linked computerised system would you be happy to pay more than the €134 per month to fund the development.

CtrlAltDelete

Avatar MIA wrote: »

I am following, fascinated.

How was your last post re Locum to do with a flawed system?

The only thing "flawed" about it is that it's not as convenient as desired. If they brought in a linked computerised system would you be happy to pay more than the €134 per month to fund the development.

Locum implied that because I had not used the same pharmacy I was always going to be charged. Fuaranach used "several pharmacies" in the same month and was fully refunded.

Yes, I'd be quite happy to pay more for a well designed, implemented system with clear guidelines. Quite a simple thing to do really in today's world. Just not in Ireland it seems.

Avatar MIA

CtrlAltDelete wrote: »

Locum implied that because I had not used the same pharmacy I was always going to be charged. Fuaranach used "several pharmacies" in the same month and was fully refunded.

He pointed it out that it could happen. That's fact and notified on the form you filled out.

CtrlAltDelete wrote: »

Yes, I'd be quite happy to pay more for a well designed, implemented system with clear guidelines. Quite a simple thing to do really in today's world. Just not in Ireland it seems.

From your extensive research name the many countries with a more efficient and beneficial service?

BTW, how much was the 32% equivalent to in cash terms that was kept back by the HSE?

duffman13

CtrlAltDelete wrote: »

Circumstances make the pharmacy closest to work the most accessable. If you read my original post you'll understand the situation I was in that lead to me starting this thread.

I was replying to Grace, I directly quoted her. I understand your original post, I was caught out a number of years ago and as such changed the way I used the service so as not to be caught out again at times of holiday etc. Granted I'm not rural so to speak so I've had more accessible options than you but if you've got one close to home that opens a Saturday then they would be where I'd be going in future.

Also I dont think anyone has disagreed with your flawed system complaints, its most definitely a flawed system that's not going to change in the short to medium term.

locum-motion

daheff wrote: »

...Also, if you do have to go to another pharmacy than your regular one, show them the DPS card & get the DPS rates.
...

Regardless of showing anyone a card, you do not become eligible to avail of what you call DPS rates until you and your family hit the threshold in that pharmacy and in that month. When the pharmacy dispenses a sub-threshold prescription on say the third of the month, they do not know if you will hit the threshold by presenting another prescription later in the month. It's a private prescription, at private prescription rates. If you later pass the threshold, the pharmacy will take into account what you paid on the 3rd, and charge you appropriately.

daheff wrote: »

...A lot of them have agreements in place that they will check with other pharmacy and you wont pay over the 134 EUR amount.

There is NO facility in place to do this. As mentioned by the OP, and clarified by me, there was originally supposed to be, but it never happened.
I have heard of cases where two pharmacies belonging to the same company have done it, but in order to do it they must create a false record in the pharmacy that is submitting the claim to the HSE under the DPS, saying that they dispensed something that they didn't dispense. As I'm sure you can appreciate, a pharmacy is legally obliged to keep accurate records as to who got what and when. Creating false records is illegal.

locum-motion

Deleted User wrote: »

Ok. Haven't read the whole thread but got medication in several pharmacies about a year ago totalling over €134 in one month. Was informed that for the cap to be in effect at time of purchase everything had to be from the one pharmacy. Was directed to HSE refund form. Filled it in and posted it to Drug Refund Section - yes, a bit of an inconvenience but I survived. They refunded me a few weeks later for the excess over €134 that month.

And thereafter the issue didn't arise as I stayed with the one pharmacy.

I suspect that if you look closely, you didn't get a full refund, and actually are in the same situation as the OP was, but didn't realise it.

locum-motion

Can I suggest to CtrlAltDelete that they should look and see who other posters are replying to before replying in turn?

Graces7

duffman13 wrote: »

Go to the one you live nearest too? Would that not make the most sense when your using a scheme like DPS. I know some people tend to bring it to the pharmacy near their jobs etc but DPS should be used in your nearest pharmacy with the best accessibility IMO.

Granted if you live somewhere really rural this is difficult sometimes to find however DPS is a good scheme despite its flaws.

OK, so that is nearly 20 miles and you have business/needs in another town 20 miles in the other direction....

I am on medical card and use whatever pharmacy I am near. They check rigorously in the computer records. Why cannot they do this with the DPS scheme? Not rocket science.. .

daheff

locum-motion wrote: »

There is NO facility in place to do this. As mentioned by the OP, and
clarified by me,

firstly, whether you want to believe or not that this happens in practice, let me confirm that i have availed of this (and not of the same group). If the pharmacies are doing something underhand, then on them be it.

and as for clarified by you.....are you the claiming to be the ultimate source of all HSE/DPS related 'fact' ?

Fann Linn

For information, I actually thought the limit for 2019 was going to be €124 as previously announced in the Budget. Went to my local chemist and was told the reduction doesn't kick in until April.

duffman13

Graces7 wrote: »

OK, so that is nearly 20 miles and you have business/needs in another town 20 miles in the other direction....

I am on medical card and use whatever pharmacy I am near. They check rigorously in the computer records. Why cannot they do this with the DPS scheme? Not rocket science.. .

Because every pharmacy is not interlinked and that's an issue with the HSE not having a centralised system set up. You can use whatever pharmacy you wish but you are gonna be liable to extra charges if your using DPS. Also with you being on a medical card, you can happily use whatever pharmacy you wish.

Graces7

duffman13 wrote: »

Because every pharmacy is not interlinked and that's an issue with the HSE not having a centralised system set up. You can use whatever pharmacy you wish but you are gonna be liable to extra charges if your using DPS. Also with you being on a medical card, you can happily use whatever pharmacy you wish.

So they need to centralise the DPS?

locum-motion

daheff wrote: »

...and as for clarified by you.....are you the claiming to be the ultimate source of all HSE/DPS related 'fact' ?

Ultimate source? No. That would be stupid.

However, since I have been working in the pharmacy business for over 30 years, a pharmacist for over 22, have been operating the DPS on a daily basis ever since it was introduced, and operated its predecessors the DCSS and the DRS before that, I think I'm qualified to comment on the ins and outs of how it was intended to work when first introduced, how it is intended to work since various changes were made, and how it actually works in practice.