Optical Benefit Schemes

Medical Card Scheme

(Community Ophthalmic Services Scheme – Health Service Executive (HSE))

If you hold a current full medical card you are entitled to a free standard eye examinations at least every two years. There may be clinical reasons for more frequent examinations.

You are also entitled to select from a  limited range of frames, a pair of spectacles at no charge.

You must obtain approval in advance from the Local Health Office that issued the Medical Card, this is usually the one covering the area where you live. The period taken to obtain approval is normally within 4 weeks of application.

Optical Benefit Scheme – Department of Social & Family Affairs (DSFA)

You may be entitled to a free standard eye examinations at least every two years. Again there may be clinical reasons for more frequent examinations.

The benefit scheme no longer provides for a limited range of spectacles at no charge. However  we have put together a special deal for those who find it difficult to afford spectacles and will supply a complete pair of spectacles including standard single vision lenses for a total cost of €45.  We hope this will soften the financial implications for those who want to continue to experience the best in eye care while keeping their cost down.

If you wish to avail of the free eye examination, approval must be obtained from DSFA. We have the application forms in each practice and can make the application on your behalf once we have your PPS number.  Once approved you may proceed to book your eye examination.  Decisions are normally made by the department within a few days.

The scheme has recently changed in the December 2009 budget and the guidance below may change.

Eligibility Criteria: ( Per DSFA @ 04/06/2009)

Qualifying Conditions in Summary

A person must have a certain number of PRSI contributions paid to qualify for Optical Benefit, either 39 or 260 according to the age of the insured person.

For persons over 21 years of age, with certain exceptions, 39 contributions must also have been paid or credited in the relevant tax year(s).

Qualified Adults (spouses or partners of qualified insured persons and subject to dependency conditions) are also entitled to Optical Benefit.

QUALIFYING CONDITIONS IN DETAIL

PRSI CONDITIONS

PRSI Classes A, E, H and P are reckonable for Treatment Benefit.

The PRSI conditions vary according to age as follows:

Aged under 21:           39 weeks PRSI paid since first starting work.

Aged 21 to 24:             39 weeks PRSI paid since first starting work,

and either:

-  39 weeks PRSI contributions* paid or

credited in the tax year on which the claim

is based.

or,

-  26 paid PRSI contributions in both the

relevant tax year and the tax year

immediately before the relevant tax year.

Aged 25 to 65:             260 weeks PRSI paid since first starting work,

and either:

39 weeks PRSI contributions* paid or

credited in the tax year on which the claim

is based.

or,

-    26 paid PRSI contributions in both the

relevant tax year and the tax year

immediately before the relevant tax year.

CLAIMS MADE IN 2010 ARE BASED ON THE 2008 TAX YEAR.

Aged 66 or

over:                260 weeks PRSI paid since first starting work

and either:

-    39 weeks PRSI contributions* paid or

credited in either of the 2 relevant tax

years on which the claim is based.

or,

-    26 paid PRSI contributions in both the

relevant tax year and the tax year

immediately before the relevant tax year.

* In the case of the 39 weeks paid or credited, a minimum of 13

weeks must be paid contributions in:

-    the relevant tax year(s) on which the claim is based  OR

-    either one of the two previous tax years  OR

-    any tax year subsequent to the relevant tax year.


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