Dáil Éireann Debate, Tuesday - 16 May 2023
718. Deputy Holly Cairns asked the Minister for Health if he will provide a separate lower rate of qualification for single-person households applying to the drugs payment scheme; and if he will make a statement on the matter. [23118/23]
View answer719. Deputy Holly Cairns asked the Minister for Health if he will provide details of the estimated cost of reducing the qualifying cost to €60 a month to avail of the drugs payment scheme; and if he will make a statement on the matter. [23119/23]
View answerI propose to take Questions Nos. 718 and 719 together.
The Health Service Executive (HSE) on behalf of the State operates two schemes which assist citizens with their medication costs. These are the Drug Payment Scheme (DPS) and the General Medical Services (GMS) Scheme.
The DPS provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.
The DPS threshold was reduced twice in 2022:
• From €114 to €100 per month on 1 January 2022.
• From €100 to €80 per month on 1 March 2022.
Therefore, currently, under the DPS, no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.
The estimated cost of reducing the DPS threshold to €60 per month is €34.8m per annum.
Considerations of further changes to the DPS threshold will be made in the context of current healthcare priorities and the budget available.
However, people who cannot, without undue hardship, arrange for the provision of medical services may be eligible for a medical card under the GMS Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.
In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Within this eligibility context, the DPS is deliberately designed as a simple universal non-means tested Scheme which is in place to protect those who do not qualify for a medical card. There is a process around means testing for medical cards which requires that the HSE consider hardship and inability to pay for required health care when making determinations around eligibility for healthcare services. The introduction of diverse DPS thresholds would introduce a level of complexity into the operation of the Scheme that is not justified when there is another Scheme in place to assist in cases of hardship.
Finally, individuals may also be entitled to claim tax relief on the cost of their medical expenses. This includes medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
