Most people who work pay pay-related social insurance (PRSI), but how many of us actually know what this entitles us to?

As PRSI is paid automatically through our employer or for those self-employed through the self-assessment system on Revenue, we often forget to avail of the benefits we are entitled to as a result.

I know I didn’t avail of my yearly dental exam or second yearly eye test, but it’s something I am going to prioritise this year. Instead of wasting these discounted treatments and payment benefits, we may as well start using them.

What is PRSI?

PRSI is a contribution most employees and employers (between the ages of 16 and pensionable age, currently 66) make to the Social Insurance Fund (SIF), which helps pay for pensions and social insurance benefits. These employees must be working full-time or part-time and earning €38 or more per week. Self-employed workers also have to pay PRSI if their income is €5,000 a year or more. Currently, the PRSI contribution is either 4% of your reckonable income (your total net family income) or an annual charge of €500 minimum. Whichever one is greater is used. In the 2023 budget, the weekly income threshold for the higher rate of employer’s PRSI was increased from €410 to €441.

Knowing your entitlements

There is a huge difference in the benefits you may be entitled to and covered under, depending on what social insurance class you fall under. This is dictated by the type of work you do and your income. In Ireland, there are 11 social insurance classes: A, B, C, D, E, H, J, K, M, S and P. Most employees are in Class A, which entitles them to the full list of social welfare benefits and payments including:

  • Adoptive benefit.
  • Carer’s benefit.
  • Illness benefit.
  • Health and safety benefit.
  • Invalidity pension.
  • Maternity benefit.
  • Occupational injuries benefits.
  • State pension (contributory).
  • Guardian’s payment.
  • Treatment benefit.
  • Jobseeker’s benefit.
  • Widow’s/widower’s pension (contributory).
  • Other classes include cover for some of the above benefits but not all. There are also extra social welfare benefits that are not listed above.

    The qualifying criteria for all benefits and classes can be found on the Department of Social Protection website.

    Self-employed PRSI contribution

    If you are self-employed, as most farmers are, and earning €5,000 or more in a year, you are required to pay PRSI under class S. When you make a PRSI contribution, your entitlements build up to social insurance benefits. Class S contributions cover you for a limited number of payments. You make your payment under the self-assessment system, and PRSI is paid to Revenue. If you satisfy all other conditions under Class S contributions you may be entitled to:

  • Paternity benefit.
  • Maternity benefit.
  • Adoptive benefit.
  • Widow’s, widower’s, or surviving civil partner’s pension.
  • State pension (contributory).
  • Invalidity pension.
  • Treatment benefit scheme – dental, hearing and optical services.
  • Availing of your benefits

    Once you know what class and subclass your income falls into, you can see what benefits you are entitled to. It is easy to avail of treatment benefit scheme services – just contact your local treatment provider with your PPS number and date of birth. They will check your eligibility on the Welfare Partners website. These benefits may only be available a certain number of times in a calendar year. To apply for other benefits listed above, contact the Department of Social Protection by emailing or phoning 017043000.

    Treatment Benefit Scheme

    Paying PRSI entitles you to treatment benefits including dental, hearing and optical services at a reduced rate. A dependant spouse, civil partner, or cohabitant of a qualified person may also be entitled to treatment benefits. To qualify for the treatment benefit scheme, you must have paid class A, E, P, H or S PRSI contributions. The amount of the contribution needed depends on your age.

    1 Dental entitlements: Approximately two million people in Ireland pay PRSI, but only 25% of those eligible claim their entitlements of an exam, scale, and polish for dental care. The treatment benefit scheme entitles PRSI workers to claim a free oral examination once in a calendar year. Since October 2017, a payment of €42 is provided towards either:

  • A scale and polish.
  • A periodontal treatment (if clinically necessary).
  • The cost of a scale and polish is capped at €15, but if the cost of either periodontal treatment or cleaning is more than €42, you must pay the difference.

    2 Hearing entitlements: Another treatment covered by the scheme is hearing services. Suppliers that have a contract with the department provide or repair hearing aids once every four years.

  • A maximum cost of €500 towards the price of each hearing aid.
  • One repair per hearing aid of a cost of up to €100 in four years
  • 3 Optical services: Under the treatment benefit scheme, you are entitled to a free eyesight test once every second calendar year. Every two years, you can also receive payment towards one pair of:

  • Reading and distance spectacles.
  • Bifocal or varifocals.
  • Contact lenses (including disposables).
  • Basic frames for glasses are free. If you choose more expensive frames, the department will pay €42 towards the cost and you will have to pay the balance. Please check with your treatment provider as you are only covered if they have a contract with the department to provide the treatment.

    Illness Benefit

    Illness benefit is a weekly payment that you may be entitled to if you cannot work due to being sick or ill. To avail of this benefit, you must be under 66 and meet the PRSI conditions. If you are medically certified as unfit for work you should apply for this payment. Illness Benefit is paid for a maximum of two years (624 payment days) if you have at least 260 weeks of PRSI contributions paid since you first started work, or one year (312 payment days) if you have between 104 and 259 weeks of PRSI.

    Case Study

    Mary is a full-time farmer aged 57 and wondering if she can get a free eye test in 2023. She hasn’t had a free eye test or new glasses since 2020.She is paying PRSI in Class S as she is self-employed. Mary has met the PRSI requirements for the treatment benefit scheme for her age group (Aged 29-65) of at least 260 paid contributions and 39 paid contributions in the governing contribution year (2021 is the governing contribution year for claims made in 2023).

    She is entitled to a free eye test in 2023 under the treatment benefit scheme as she meets the PRSI contributions and hasn’t had an eye test in the last two years. If Mary requires new reading glasses, she can also get basic frames for free.

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