Pay Related Social Insurance (PRSI) contributions are paid into the Social Insurance Fund (SIF) which helps pay for benefits and pensions. These contributions, in return, entitle you to certain health services and leave when required.

In 2023, over €1.7m claims were paid under the scheme at a cost of almost €133m. Some individuals may have made more than one claim in 2023 e.g., dental and optical claims.

PRSI entitlements

The Treatment Benefit Scheme run by the Department of Social Protection (DSP), provides a contribution towards dental, optical and aural services. It is available to insured workers, the self-employed and retired people who have the required number of PRSI contributions. It covers:

• Dental benefit: The DSP pays the full cost of an oral dental examination once a year. There is also a payment of €42 towards a scale and polish. If the cost is more than that, you pay the balance (capped at €15). If clinically required, periodontal treatment is available once a calendar year. You might also be entitled to tax relief on certain non-routine dental treatments.

• Optical benefit: Every two years you are entitled to a free eye test. You can get a set payment, once every two years, towards either one pair each of reading and distance glasses, one pair of bifocal or varifocals or one pair of contact lenses (including disposables). When selecting your glasses, the basic frames are free. If you choose more expensive frames, the department will pay €42 towards the overall cost and you pay the balance. If you need contact lenses for medical reasons, you can get up to €1,000 towards the cost of a pair of medical contact lenses (€500 for each contact lens) once every two years.

• Hearing benefit: The DSP pays the full cost of a hearing aid up to a maximum of €500 (€1,000 for a pair) once every four years. You can also claim the cost of repairs, up to a maximum of €100, once every four years.

• Hairpiece or wig: You are entitled to up to €500 for one hair replacement item such as a hairpiece or wig, in a year. It does not cover surgical treatments. Hair loss must be from a disease or treatment of a disease such as cancer or alopecia. The types of alopecia covered are: alopecia areata, primary scarring alopecias, frontal fibrosing alopecia and lichen planopilaris, chemotherapy-induced alopecia and lastly, alopecia resulting from surgery or trauma, including burns.

How to access entitlements:

In order to qualify for Treatment Benefit you must have paid Class A, E, P, H or S social insurance contributions, and the amount you need depends on your age. To view the full age criteria visit: citizensinformation.ie

Claims can be made through your health provider, who can check your entitlements in advance of the treatment and claim payment back afterwords.

In order to identify you as an employee, they will need your date of birth and PPS number.

Farmer PRSI entitlements

Since 2017, the Treatment Benefit Scheme was extended to cover self- employed people who pay Class S PRSI, which includes most, if not all, farmers.This entitles farmers who are paying the correct contributions to free dental and optical exams as outlined above. For more information visit citizensinformation.ie

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