# Drugs Payment Scheme - inadvertently paying more than €90 p.m.



## ClubMan (22 Dec 2008)

If you have a _Drug Payment Scheme _card which means that expenditure on prescribed drugs is capped at €90 p.m. but you inadvertently pay more than that (e.g. by not using the same pharmacist as normal, forgetting to present the card etc.) is there any way to claim back the excess over the €90?

Also - if a spouse holds the card what is the procedure for adding the other spouse and kids to it?


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## z109 (22 Dec 2008)

ClubMan said:


> Also - if a spouse holds the card what is the procedure for adding the other spouse and kids to it?


We have four cards (one each) all with my PPS number on them. I don't think the system does family cards! (Like many other things the system doesn't do). As it's a family based payment, you all have to get your drugs from the one pharmacy in the calendar month. Once you have had a prescription from a particular pharmacy, they should have your details on their system so your shouldn't have to have your card the next time.

On your other question, ask a pharmacist, would be my advice. Mrs. YM. says that they seem to know the foibles of the system and what to do about them. The answer might be "tough", though!


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## lukegriffen (22 Dec 2008)

I'm pretty sure you send the receipts to your local health office, probably along with your card number etc.
I couldn't find this mentioned explicitly, but the last 3 lines of the link at end indicate that they are involved in refunds ....

"Your application for a new Card can take up to 4 weeks to process. If you incur any expenses during this period, retain your receipts until you receive your Card and forward the receipts to the Drugs Payments Scheme Division of your Local Health Office."


[broken link removed]


Oh, and here's the link to the application form.  You can just add spouse and children to an existing card, if you wish...
And send it back to your local health office.  

[broken link removed]


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## ClubMan (22 Dec 2008)

Thanks.


yoganmahew said:


> We have four cards (one each) all with my PPS number on them. I don't think the system does family cards! (Like many other things the system doesn't do).


I know that each member of the family needs their own card. I would have thought that each would have the individual's own _PPSN _on it (including children). Same as _EHICs _etc.


> As it's a family based payment, you all have to get your drugs from the one pharmacy in the calendar month. Once you have had a prescription from a particular pharmacy, they should have your details on their system so your shouldn't have to have your card the next time.


While this seems to be common what I've read about the scheme suggests that most or all pharmacies should be hooked into the system so it should be possible to shop around and not be tied to the one pharmacy.


> On your other question, ask a pharmacist, would be my advice. Mrs. YM. says that they seem to know the foibles of the system and what to do about them. The answer might be "tough", though!


Other stuff that I've read suggests that any excess payments over the €90 per (28 day?) month can be reclaimed but I can't find any details. I'll ask the pharmacy or the _Public Health Nurse _so.


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## tinkerbell (24 Dec 2008)

We have individual cards - mine, OH, and three kids but my PPS number features on them all as I applied as the "lead" member as it were!   Important point is that it clearly states on form that comes with card "Where possible you should attend the same pharmacy in any one calendar month.  If you attend more than one pharmacy in a calendar month you will have to pay the relevant monthly threshold and claim the excess expenditure from your local health office".


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## ClubMan (24 Dec 2008)

tinkerbell said:


> If you attend more than one pharmacy in a calendar month you will have to pay the relevant monthly threshold and claim the excess expenditure from your local health office".


Anybody know of any info about this process?


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## justsally (24 Dec 2008)

Is this of any help


[broken link removed]

You do not have to register with a particular Pharmacy for the scheme but for convenience it is advisable to use the same pharmacy in a particular month if you wish to avoid paying more than the maximum amount per month.

Where people need to use two or more pharmacies in one month, they can claim back the amount paid over the threshold from their Local Health Office.


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## allthedoyles (24 Dec 2008)

ClubMan said:


> Anybody know of any info about this process?


 
I have often claimed the excess expenditure from HSE Local Head office .
I also have a copy of Claim Form in PDF format ...anyone want it emailed , please send me message ..........

I also believe that some pharmacies are hooked up to system , and it should be possible to use different pharmacies in same calendar month.

If its necessary to use different Pharmacy and you exceed the monthly limit , why not bring a copy of previous receipt along to confirm amount already used in that month.

Some of my local pharmacies keep the prescription on file for 2 reasons :
1. To ensure you dont exceed the monthly limit
2. To ensure you shop there again


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## Smashbox (27 Dec 2008)

I have had to claim before, the chemist should insert a paper printout with your prescription meds in order to claim back the overs.

As a side note, I always use the one chemist to avoid overpaying the amount. Even small amounts build up, and its best you dont have to pay in the first place in case you forget to claim.


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## sammya (28 Dec 2008)

I recently came across this situation and the pharmacy did not collect any money over the €90.00 mark. They just asked me to sign the claim form & that was it. I always use the same pharmacy.


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## ClubMan (30 Dec 2008)

Thanks all - I'll contact our _Public Health Nurse _in the new year for clarification on what _HSE _office we should contact as I have always found it difficult to figure out which office deals with which issues. THe overpayment arose because the same pharmacy was not used for all purchases.


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## Galwaygirl (30 Dec 2008)

Clubman, would you mind updating us on how you get on as I have similar issues myself with myself and hubby using different chemists (I used the correct one of course!!!) 
On another note, I also had a prescription for 2 months supply of drugs, the chemist wanted to dispense 2 weeks at a time which would have cost me 144 euro over the two months. I insisted on getting the full prescription so paid 90. Does anyone know why the chemist was reluctant to dispense fully? It wasn't a repeat prescription, just one for 2 months worth of drugs. Was wondering if goverment guidelines or something to do with what the chemist can claim.


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## WaterSprite (30 Dec 2008)

Galwaygirl said:


> Clubman, would you mind updating us on how you get on as I have similar issues myself with myself and hubby using different chemists (I used the correct one of course!!!)
> On another note, I also had a prescription for 2 months supply of drugs, the chemist wanted to dispense 2 weeks at a time which would have cost me 144 euro over the two months. I insisted on getting the full prescription so paid 90. Does anyone know why the chemist was reluctant to dispense fully? It wasn't a repeat prescription, just one for 2 months worth of drugs. Was wondering if goverment guidelines or something to do with what the chemist can claim.



I think (from previous experience) that you can only claim for drugs that are to be consumed in that month - so, for example, if you get 6-months of medications in one go, you can only put one month's worth of it towards your €90 in that month.  So I think you were lucky that the pharmacist agreed to allow you to put the whole lot against a single month.


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## FredBloggs (30 Dec 2008)

Galwaygirl said:


> Clubman, would you mind updating us on how you get on as I have similar issues myself with myself and hubby using different chemists (I used the correct one of course!!!)
> On another note, I also had a prescription for 2 months supply of drugs, the chemist wanted to dispense 2 weeks at a time which would have cost me 144 euro over the two months. I insisted on getting the full prescription so paid 90. Does anyone know why the chemist was reluctant to dispense fully? It wasn't a repeat prescription, just one for 2 months worth of drugs. Was wondering if goverment guidelines or something to do with what the chemist can claim.


 
I have claimed back excess in the past from my local health board no problem.  there is a form you need to send in with the copy receipts.  I'll have a look and see if I can find a link to one.  I usually do so once a year when I'm doing my tax return as you can't claim more than the €90pm on your Med 1.  some months I'm only claiming €3 0r €4 which wouldn't be worthwhile on their own but when you're doing a whole year and are set up for the refunds you zip through it.
Be prepared for a long wait to get paid - but you will be paid.


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## ClubMan (30 Dec 2008)

FredBloggs said:


> I have claimed back excess in the past from my local health board no problem.  there is a form you need to send in with the copy receipts.  I'll have a look and see if I can find a link to one.


Thanks.


> I usually do so once a year when I'm doing my tax return as you can't claim more than the €90pm on your Med 1.


I don't understand. There is no *Revenue *hard limit of €90 p.m. on expenses qualifying for _MED1 _tax relief.


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## FredBloggs (30 Dec 2008)

ClubMan said:


> Thanks.
> 
> I don't understand. There is no *Revenue *hard limit of €90 p.m. on expenses qualifying for _MED1 _tax relief.


 
I think there is - from my reading of the Med 1 wording

*Drugs & Medicines: *Since the 01/01/05 you can claim tax relief for expenditure of amounts up to £85 from calendar month
for prescribed medication. Expenditure in excess of £85 per month is recoverable from the Health Service Executive under the
Drugs Payment Scheme. Prior to 01/01/05 the monthly excess figure on expenditure incurred was:-
_ 01/01/04 - 31/12/04 - £78 _ 01/01/03 - 31/12/03 - £70

Obviously the €85 is now €90.  Anyway its better to get 100% of the excess from your health board than only a % from the Revenue.

Well worth doing.


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## ClubMan (30 Dec 2008)

Ah - I see what you mean now. But it's not clear if _Revenue _actually enforce this limit if (for whatever reason) one (a) does not avail of the _Drugs Payment Scheme_ and/or (b) claims tax relief on prescribed medication expenditure in excess of €90 p.m. Obviously one cannot claim tax relief on expenses reimbursed through some other means (e.g. _Drugs Payment Scheme_, private health insurance etc.).


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## allthedoyles (31 Dec 2008)

Clubman is correct......Its not clear if Revenue enforce this limit.........However it is your duty to fill in form Med 1 correctly and deduct the excess of 90 e form your claim form ...

An important point to note is that when claiming excess payment from your local HSE , you MUST send in the ORIGINAL chemist receipt ( signed ) 

Otherwise your claim will be returned unpaid .


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## ClubMan (31 Dec 2008)

allthedoyles said:


> Clubman is correct......Its not clear if Revenue enforce this limit.........However it is your duty to fill in form Med 1 correctly and deduct the excess of 90 e form your claim form ...


Eh? That makes no sense either. The €90 is not an excess. It's what you personally pay per month if you avail of the _DPS _and thus is the amount on which you can claim tax relief. If you don't avail of the _DPS _(for whatever reason) then presumably you can claim tax relief on total expenditure not just €90. In fact many people will periodically pay more than €90 in one month but not on an ongoing basis and just claim tax relief but not bother with the _DPS _for the odd month here or there (if that's even possible) I would imagine. I know I did in the past but more recently the family's regular monthly expenditure is more than €90 so we do avail of the _DPS_.


> An important point to note is that when claiming excess payment from your local HSE , you MUST send in the ORIGINAL chemist receipt ( signed )


You mean the top copy and keep the carbon copy? And do you mean stamped as opposed to signed?


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## FredBloggs (31 Dec 2008)

ClubMan said:


> You mean the top copy and keep the carbon copy? And do you mean stamped as opposed to signed?


 
You have to send in the top copy and I think he means signed.  You need to sign all the prescription claoim forms in the bottom right hand corner where it says "received by"


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## allthedoyles (31 Dec 2008)

Correct Clubman......You can claim either one or the other....

If you read the form Med1 carefully , it states that ''you cannot claim tax relief for sums received or due to be received from eg. Health Service Executive 
You must give details of such amounts and deduct them from the amount claimed on claim form .''


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## margaret1 (5 Mar 2009)

There is alot of talk at the moment about the actual cost of the drugs we are taking and for most people lucky enough to be on the DPS, it is a fact we often do not consider. We as a family are on the DPS and we are interrested in knowing the cost of individual drugs (varies from 4-6 prescriptions per month), however, the chemsit just prints the name of the drugs and the just the combined total owed under the DPS scheme, therefore once the max of e100 is paid the drug cost will show as zero! I have questioned the chemist about a breakdown of the actual cost if we were not using the DPS, but it appears they consider this a complication.
I have a few queries for the forum. Is it standard for DPS customers not to be aware of the actual cost of the Drugs they are prescribed? Could it be possible that drugs are priced differently at the chemsit for a customer on the DPS? Are drugs standard price in every chemsit or is it worth pricing around?


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## Protocol (5 Mar 2009)

The govt agrees a price with the manufacturers.

Let's assume a drug for 100 euro.

There are 3 drug wholesalers.

The Govt agreed to let them have a 17.64% margin.

The Govt pay the pharmacy 117.64 euro.

The pharmacy are paid a dispensing fee of approx 2.50-3.60.

For medical card patients they have no mark-up on the 117.64.

For DPS they mark-up by 50%, so the selling price is 176.46.


*Price competition.*

At the supplier level = none

At the wholesaler level = none

BUT, the wholesaler do give the pharmacy maybe 8-10% discount, so in fact the pharmacy actually pay maybe 110 for the drug.

At the retail level = none


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## MaryBe (5 Mar 2009)

I got a prescription last month from my local chemist and the €90 as reported in this thread is now €100.00 I didn't read or hear anything about this increase!!!!


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## Fatphrog (5 Mar 2009)

[broken link removed]

The increase was fairly widely publicised.


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## margaret1 (6 Mar 2009)

Thank you so much Protocal, that makes perfect sense now. I have ingredient cost from chemist so I have managed to balance exactly and now I will know(info purposes only) exactly what each drug is actually costing each month (over and above what we actually pay on DPS).


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