Open wide, this is going to hurt . . . your wallet

Consumers face big bills for previously ‘free’ health treatments as Budget cutbacks kick in

WE ALL know how physically painful a trip to the dentist can be, but the decision in December’s Budget to pull back dental benefits given to those with sufficient PRSI stamps, means that it’s now going to hurt your wallet a lot as well. Moreover, if you’re used to getting money off your glasses you will also find that this is no longer the case.

As of January 1st, in a move aimed at saving €54 million a year, the Treatment Benefit Scheme is being restricted to just free dental and optical examinations.

The decision will affect almost two million people, although if you recently had treatment, which was not completed before January 1st of this year, you should still be covered under the old arrangements, provided eligibility was established before the end of last year.

According to the Department of Social and Family Affairs, it has processed in excess of 150,000 inquiries from dentists about the eligibility of customers under the old rules. While there was a delay in dealing with these, all enquiries were processed by last Friday.

Once approved, treatment needs to commence within three months of this date, and must be completed within six months of commencing, in order to get full benefits.

For the over-70s, the cutbacks will hit hard, coming as it does a year after the clampdown on eligibility for medical cards, which excluded many from automatically qualifying for one.

DENTAL BENEFITS

Previously, provided you had the requisite social insurance contributions, you were entitled to two free dental examinations a year, a teeth cleaning session, as well as discounts on a host of other treatments such as fillings, extractions, root canal work or dentures.

Now, however, you will be entitled to only one free check-up a year. While this may still save you about €50, you will now have to pay full price for fillings, which can cost up to €150 per tooth; extractions, which can cost €200 per tooth; root canals, which cost about €500; and dentures, which would typically set someone back anything up to about €1,000.

As Fintan Hourihan, chief executive of the Irish Dental Association (IDA), points out, you may well ask yourself, “why am I paying €53 a week and getting no benefit in return, other than an annual check-up?”.

On the plus side, however, the move may act as an incentive for dentists to keep their prices down.

Given that they are already competing with cheaper services both north of the Border and further afield, local dentists will have to stay competitive.

Hourihan acknowledges the pressure on prices, saying that many dentists have already frozen or cut their charges.

“However, there are limits to how much they can reduce their fees, and the concern is that there will be a race to the bottom,” he adds.

OPTICAL BENEFITS

If you have benefited in the past from free glasses from the State, you will find that this is no longer the case as of January 1st.

Previously, a limited range of free glasses were provided under the Optical Benefit Scheme, while a grant towards a wider range of spectacles and contact lenses was also available. However, this has taken a similar hit to the dental scheme, and from now on, only a free eye examination will be available, although a contribution towards contact lenses will still be granted, provided you have an eye condition that makes wearing glasses impossible.

AURAL BENEFITS

The one benefit that hasn’t been diluted is aural, with no changes announced in the Budget. The Department of Social and Family Affairs will still pay half the cost of a hearing aid, subject to a fixed maximum of €760 for each hearing aid every two years, as well as half the cost of repairs needed.

IMPACT ON MEDICAL CARD HOLDERS

If you have a medical card, you may also find that access to dental services will be limited in 2010.

The Dental Treatment Services Scheme currently entitles adult medical card holders to obtain dental services from dentists in private practice under contract to the HSE. The range of treatment items available includes examination, X-ray investigations, fillings, extractions, oral surgery, partial and full dentures, periodontal (gum) treatments and root fillings, and treatment is free to the patient.

However, expenditure in this scheme has risen by 60 per cent over the past five years and, as such, in the Budget the Government said it would look for savings of some €30 million this year. For medical card holders, this means that once the €63 million allocated to the scheme for 2010 is paid out, access to services may be limited.

According to Hourihan, this move from a demand-led to a budget-led scheme will “see the rationing of services and may well mean waiting periods for dental patients”. In addition, with rising unemployment driving up demand for medical cards, it may mean that the number of people seeking free treatment will increase significantly this year, despite the decrease in spending.

BOOST YOUR INSURANCE

If you’re worried about the potential impact on the cost of dental and optical care for your family as a result of the move, you could consider taking out an insurance policy to protect you.

The VHI, for example, has a specialist dental policy, which it operates alongside US dental

insurance management company, DeCare.

The plan, which costs €227.74 a year per adult, covers dental charges of up to €1,500 every year, including 100 per cent of examinations and cleanings, 70 per cent of the costs of fillings and extractions, and 25 per cent of the cost of dentures.

With regard to optical cover, if you already have private health insurance, you may find that you can claim back some optical

costs under these policies, as most health insurance schemes provide some level of cover for optician’s fees.

KNOW THE DRILL: WHAT A VISIT TO THE DENTIST SHOULD COST YOU

CONFUSION ABOUT the cost of dental services has increased since the Government reduced its dental spending in December’s budget and dramatically cut the amount of free treatments available to PRSI patients.

One reader contacted The Irish Timeslast week to complain about being given two wildly different quotes for a check-up and clean on two occasions he contacted his dental practice early last month.

Initially the reader was told the cost would be €100 but when he contacted a second dentist in the same practice the price of the treatment suddenly fell to €60, with the check-up being offered at no cost under the much-reduced PRSI scheme.

The confusion has not been helped by a wide divergence in the price of a check-up which appears to exist across the State with some dentists routinely offering check-ups at no cost to consumers and others charging as much as €70.

With such price variations, it can be difficult for people to establish what is a reasonable price for the most basic treatments offered by dentists.

Transparency is not aided by the reluctance of many dental practices to display clear and unambiguous price lists in their surgeries.

While the Irish Dental Association is reluctant to discuss any aspect of the fees its members charge because of fears it will be accused of engaging in anti-competitive practices, a spokeswoman told The Irish Timesthat a check-up should cost somewhere between €30 and €50.

The Smiles Dental Group, which has nine branches across the country, charges €40 for a basic check-up, the same price that Paul O’Dwyer, a Tipperary-based dentist charges.

He says it has been difficult explaining to some of his patients in recent weeks that as a result of the Budget changes – which he describes as very short sighted and ultimately counterproductive – he has had no option but to charge for some services that had previously been free, but says that when all the costs are factored in it would be very difficult to charge less than that.

He does add, however, that dentists should not need to charge anything more than €50 for a check-up.

He accepts that some dentists do offer free check-ups, but says most who are in a position to do this have long-established practices and have significantly reduced overheads.

“I do know that some dentists do offer free check-ups, but it tends to be a loss leader and something of an age-dependent thing, and I would imagine you would find it hard to find a dentist under 40 who can afford to do that.”

– CONOR POPE