Written answers

Wednesday, 8 December 2021

Department of Health

Departmental Schemes

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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155. To ask the Minister for Health if he has considered including women with gestational diabetes on the long-term illness scheme for the duration of pregnancy which is recommended in a submission (details supplied); and if he will make a statement on the matter. [60728/21]

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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The Long Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.

Under the Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.

Gestational diabetes is not a permanent or long-term illness and is, therefore, not covered by the LTI scheme. There are currently no plans to make specific provision for gestational diabetes under any new or existing health scheme. However, a review of the current eligibility framework, including the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy.

In the meantime, for people who are not eligible for the LTI scheme, there are other arrangements which protect them from excessive medicine costs.

Under the Drugs Payment Scheme (DPS), no individual or family pays more than €114 a month towards the cost of approved prescribed medicines. The maximum payable under the DPS will be further reduced to €100 per month from 1 January 2022. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.

People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. 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.

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%.


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