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Treatment Benefit Scheme Eligibility

Dáil Éireann Debate, Tuesday - 17 September 2019

Tuesday, 17 September 2019

Questions (617)

Marcella Corcoran Kennedy


617. Deputy Marcella Corcoran Kennedy asked the Minister for Employment Affairs and Social Protection the way in which a person that is estranged from their spouse can access dental benefit on the basis of the PRSI contributions of their spouse without having to have their spouse complete and sign form D2; and if she will make a statement on the matter. [36993/19]

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Written answers (Question to Employment)

A person can qualify for treatment benefit in two ways, either using their own PRSI record if they have the required contributions or by using their spouse’s/partner’s record if they are financially dependent on their spouse or partner.

When a person wishes to claim treatment benefit under the dependent spouse scheme, based on their spouse’s/partner’s PRSI record, they are required to complete a dependent spouse application form)eligibility check form (DE2), available from the service provider they intend to use or directly from the Department.  In order to determine eligibility the Department has to confirm that the insured spouse/partner satisfies the PRSI contributions requirement and that the person seeking treatment benefit is financially dependent on the qualified person.

To ensure data protection compliance (including the General Data Protection Regulation legislation) the Department seeks the written consent of both parties to their data being used to make the necessary enquires to check eligibility.   The “qualified” PRSI contributor is asked to consent to the use of their PPS number by the Department, so that their PRSI record can be accessed to potentially qualify their dependent spouse/partner for treatment benefits.

It should be noted that the “qualified” spouse/partner is not asked to consent to their spouse getting the treatment, but is asked to consent to the use of their PPSN by the Department.  Where a dependent spouse/partner indicates to the Department that they do not wish to, or are not in a position to ask their spouse/partner to sign the form, the Department can still proceed to determine eligibility.  A protocol is in place to cover such instances and is in operation in relation to all schemes and services of the Department.

The person concerned should complete the DE2 form and indicate on part 2 that they are separated from their spouse.  In such circumstances the spousal declaration need not be completed. On submission of the form the Department will proceed to take the necessary steps to confirm eligibility. 

I hope this clarifies the matter for the deputy.