This is a reasonable summary of entitlements for people with Type 1 or Type 2 diabetes and their carers. However, if you are aware of others, Diabetes Ireland would like to hear from you. The information provided is for guidance only, please refer to the official sites for full details – www.revenue.ie and www.welfare.ie.
For help with accessing information, completing forms or non-judgemental information on your entitlements, contact your local office of the Citizens Information Service. For details please see http://www.citizensinformation.ie/en/.
This section covers the following topics:
- Entitlements for Diabetes Management
- Long Term Illness Scheme
- Medical Card or GP visit card
- Eye Checks
- Foot Checks
- Other Entitlements that may be applicable
- Carer’s Allowance
- Entitlements around Employment/ Education
- Employment
Entitlements for Diabetes Management
Long Term Illness Scheme
Everyone with Type 1 or Type 2 diabetes (does not include gestational diabetes) is entitled to a Long term illness (LTI) card. There is no means test for the scheme. You may hold a medical card and a LTI card. The card issued by the HSE entitles you to receive diabetes medications and medications for associated conditions such as some blood thinners, cholesterol lowering and blood pressure medication, pens/syringes lancets, blood glucose monitoring strips (if required) free of charge once prescribed by your diabetes team. You do not pay the prescription dispense charge on LTI items.
You can download an application form on www.mylti.ie or call 0818 22 44 78 to make enquiries. The application form requires your name, address, PPS number and a medical report i.e. section 2 of the form completed by your doctor/hospital consultant. Once completed return to: LTI Client Registration Unit, PO Box 12962, Dublin 11,D11 XFF3. NOTE – this is a change of address, previously the form was returned to your local community health office.
Newly diagnosed with Diabetes – ask your pharmacist to register you for an emergency temporary 2 month LTI scheme access while you complete your application (Note – this is new in 2019).
With an LTI card, you do not have to pay a prescription charge for medicines prescribed by your diabetes team if they are on the list on page 11 of https://www2.hse.ie/file-library/long-term-illness/guide-to-the-long-term-illness-scheme.pdf
Medical Card or GP Visit Card
You may also be eligible for a Medical Card or a GP visit card depending on your circumstances that is the application is initially means tested and if above the threshold, you can appeal under the chronic illness medical requirement (through your doctor effective from late 2014). A Medical card will entitle you to free GP care & Hospital visits.
With a medical card you are also exempt from the health levy or exam fees for children. In some cases, medical card holders may be able to get expenses involved in travelling to out-patient services. To qualify for a medical card, most people have to have means below certain limits or have a doctor make special application based on current medical condition. The GP Visit Card allows individuals and families in Ireland to visit their family doctor for free. Only the cost of visits to your family doctor is free; you must pay for prescribed drugs, medicines and other health services similar to others who don’t have a Medical Card. Diabetes related medication, as above, will be free of charge under the LTI scheme.
Eye Checks
For people with diabetes aged 12 or over, the National Diabetic Retinal Screening Programme offers free, regular screening for diabetic retinopathy, a complication of diabetes that can damage your eyesight. For more information see www.diabeticretinascreen.ie. You can check if you are on the eye screening register you can phone 1800 45 45 55 and choose option 4. If you are not on the register a health professional, your G.P can put you on the register on line or by also phoning 1800 45 45 55.
Visual Difficulties
A person may be registered blind but still have some vision. A “blind” person may be entitled to other payments based on their sight loss e.g. Blind person’s Allowance, Blind Welfare Allowance, Blind Person’s Tax Free Allowance, Free Travel and Access to the services of the National Council for The Blind in Ireland (PV Doyle House, Whitworth Road, Drumcondra, Dublin 9. Telephone 01 8307033, Fax 01 8307787, email; [email protected]). They may also claim and be means tested for Carer’s Allowance, Disability Allowance, Guide Dog Allowance, Companion Travel, Electricity Allowance, Television Allowance, Incapacity Benefit, Low Vision Aids and Telephone Allowance.
Foot Checks
Chiropodists/podiatrists assess diagnose and treat conditions and abnormalities of the foot and lower limb. Podiatry services can significantly improve peoples’ quality of life by alleviating painful symptoms, and promoting and maintaining mobility. The Health Service Executive (HSE) is not legally obliged to provide chiropody/podiatry services but where they do, services may be provided by the Local Health Office or by voluntary organizations on behalf of the HSE.
Where the service is available, it is free to medical card holders. People over 65 years of age have free access to community podiatry services where they are available. If your GP is part of the HSE National diabetes footcare screening programme (still becoming established) once assessed and if deemed at risk, you can be referred to the appropriate podiatrist or hospital foot protection team. There would be no charge for this service.
Diabetes Ireland provide a reduced cost service to members. For more information please see our care centres.
Tax Relief and Chiropody Services
Non-medical card holders may be able to claim tax relief on health services such as podiatry care if you are required to attend as part of medical treatment. (That is, you have a significant disability or a serious illness, etc. and your doctor directs you to attend). You may also be able to claim tax relief on any doctor’s visits and prescription drugs associated with this care. See Tax allowances below.
Other Entitlements that may be applicable
The list below is in alphabetical order based on the name, they are called:
Carer’s Allowance is a payment to people on low incomes who are looking after a person who needs support because of age, disability or illness. You must reside with, or near the person and provide full time care and attention to that person. The person must be over 16 years of age or if less than 16 years of age be in receipt of the Domiciliary Care Allowance.
The Carer’s allowance is means tested but any payment made by the Department of Social Protection is not taken into account in the means test and the family home is also excluded. For more information see http://www.welfare.ie/en/Pages/ca.aspx . If you are a full time carer in receipt of the Carer’s Allowance, you spouse/partner if jointly assessed for tax purposes may be entitled to additional tax credits.
Carer’s Benefit is a social insurance payment made to someone who gives up work to care for an incapacitated person i.e. available to insured people who leave the workforce to care for a person(s) in need of full-time care and attention. You can get Carer’s Benefit for a total period of 104 weeks for each person being cared for. This may be claimed as a single continuous period or in any number of separate periods up to a total of 104 weeks. However, if you claim Carer’s Benefit for less than six consecutive weeks in any given period you must wait for a further six weeks before you can claim Carer’s Benefit to care for the same person again. You are awarded credited contributions (your personal entitlement for future social welfare payments) or credits automatically when you are getting Carer’s Benefit. Credits are awarded at the same rate as your last paid contribution.
Additional information: The Carer’s Leave Act 2001 allows employees to leave their employment temporarily to provide full-time care for someone in need of full-time care and attention. You are entitled to take carer’s leave for a minimum 13 weeks up to a maximum of 104 weeks. Carer’s leave from employment is unpaid but the Carer’s Leave Act ensures that those who propose to avail of carer’s leave will have their jobs kept open for them for the duration of the leave. Taking carer’s leave may entitle you to additional tax relief.
Dental Services
If you hold a medical card the Dental Treatment Services Scheme may provide treatment for peridontal/ gum disease in cases where care is especially warranted and prescribed by your medical team. For further information contact your local health office
http://www.citizensinformation.ie/en/search/?q=dental
Domicilary Care Allowance (DCA)
The issue of Domiciliary Care Allowance comes up often in relation to younger children with diabetes. According to the Department of Social and Family Affairs, the payment is a monthly allowance payable to the carer of a child less than 16 years of age where the child needs constant care and supervision, substantially more that the child of the same age without the disability would require.
(This definition raises issues for Diabetes Ireland as the majority of parents of children with diabetes do not wish us to use the word disability in relation to Type 1 diabetes.) However, an application can be made regarding the level of daily supervision/monitoring required maintaining /supporting the child’s daily health and keeping them free from acute diabetes complications. The DCA is available to parents/guardians of children from birth to age 16 yrs. Eligibility is determined primarily by the degree of additional care and attention required by the child rather than to the type of disability involved. See DCA Medical Guidelines (pdf) and http://www.welfare.ie/en/downloads/sw127.pdf. Approval of the DCA automatically includes a medical card for the child and the continuation of medical card eligibility post the child’s 16th birthday without family means being considered.
Dietary Support
There is no dietary supplement but a person already receiving a social welfare payment may apply to their local welfare officer to have a discretionary additional payment. For more information see http://www.citizensinformation.ie/en/social_welfare/social_welfare_payments/supplementary_welfare_schemes/supplementary_welfare_allow.html In addition, a person may be able to claim Tax relief on foods used to treat hypoglyceamia or purchased as part of a dietary plan – For more information see https://www.revenue.ie/en/personal-tax-credits-reliefs-and-exemptions/health-and-age/health-expenses/additional-diet-expenses-for-coeliacs-and-diabetics.aspx
Invalidity Pension
This is payable weekly to a person who has been incapable of work for 12 months and will continue to be for at least another 12 months. It may be possible to go straight onto invalidity pension from another social welfare payment if the illness or disability is such that you are unlikely to work for the rest of your life. For more information see www.welfare.ie
Supplementary Welfare Allowance
This is a means tested social welfare payment that is administrated by the local community welfare officer to people in hardship who already receive a social welfare payment. Anyone whose means are insufficient to meet their needs may apply. The supplementary payment may be weekly to ensure minimum income level, towards rent, mortgage repayments or special dietary/ heating needs or a once off payment to cover urgent cases. Apply to the Community Welfare officer at your local health centre. Appeals may be made to the Appeals Officer at the health board offices.
Tax Allowances
An additional tax allowances that apply to tax–payers, e.g. blind persons allowance, guide dog allowance, incapacitated child allowance (child must be permanently incapacitated either mentally or physically), home carer’s allowance, or dependent relative allowance. You need to apply to your local PAYE office.
People caring for people with diabetes are not entitled to additional tax credits other than for Carer’s Tax Credits which is available to a couple in a marriage or civil partnership where one spouse or civil partner is the Home Carer and cares for one/more dependent persons and the carer’s income does exceed €5,080 for the tax year (Carer’s Allowance is not taken into account for determining restriction, but is a taxable source of income). The dependent must be a child in receipt of a Department of Social Protection Child Benefit payment or an adult over 65 years of age. For more information see http://www.revenue.ie/en/tax/it/credits/home-carers.html
Tax Relief on Medical Expenses
You can claim tax relief on general medical expenses, cost of doctors and consultants fees and certain items/medications prescribed by doctors. You can also claim back glucometer costs if personally purchased and chiropody/podiatry services or similar treatments. You cannot get tax relief for routine ophthalmic and dental care. However, there are certain dental treatments that do qualify for tax relief for example crowns, veneers and root canal treatment.
You can claim tax relief online using Revenue’s myAccount service. You can also access the myAccount service on mobile and tablet devices using Revenue’s RevApp.
You can also claim medical expenses relief offline by completing a paper Form 12 (pdf) and returning it to your Revenue office. You can request a Form 12 by calling Revenue at 1890 30 67 06 and giving your name, your full postal address, your Personal Public Service (PPS) number and the number of forms you need. (If calling from outside the Republic of Ireland please call +353 1 70 23 050.) Alternatively, you can email these details to [email protected].
You can only claim for medical expenses if you have receipts to prove your claim. Revenue’s myAccount service includes a receipts tracker service which allows you to store your receipt details online. If you don’t use this service, you must keep your medical receipts for six years because Revenue may investigate your claim.
A medical form MED2 (pdf) is a receipt to prove your dental expenses. Your dentist will normally have a supply of MED 2 forms and should complete it for you.
Additional Information on Medical Expenses
Diabetes is a lifelong condition and therefore meets the definition under Revenue guidelines as a disability. This means you can claim relief on the cost of health expenses at your standard rate of tax i.e. 20%. These can be your own health expenses, those of a family member or any individual’s, as long as you paid for them.
You must keep receipts and documentation from your doctor that they were necessary to the management of your lifelong condition e.g. dietary products, purchase of exercise bike in type 2 diabetes, blood testing equipment, batteries for diabetes devices etc. You can also claim relief for the cost of transporting your child to and from hospital or claim for transport to visit your child in hospital. For more information see citizen information http://www.citizensinformation.ie/en/
Reclaiming Vat on Medical Expenses
Reclaiming VAT on medical appliances e.g. Flash or continuous glucose monitoring systems or any other devices used on the recommendation of a medical practitioner. This procedure has not yet been tested for fitness trackers/wearables or exercise bicycles.
- Register with ROS.ie so process can be completed online
- Get a letter from your doctor saying you have diabetes and that the doctor would recommend that you use the appliance as part of the management of diabetes. This letter does not need to be submitted but is essential if audited.
- Print off all your paid receipt – For Abbott Freestyle LIBRE, this will need to be requested from Abbott directly as the invoice or order form does not indicate payment. You can try marking them as paid and keep copies of visa statements etc. to show payment if audited
- Log onto ROS.ie and click on eRepayments in the payments/repayments box
- On the eRepayments page click:
- Make a claim
- VAT
- Form 61A aids an appliances for persons with disabilities
- follow the 5 steps outlined
There is no limit on the number of claims per year you can make however, more than 2 may result in an audit.
Reclaiming VAT does not affect your Med 1 entitlement for tax rebates as you reclaim the cost not recoupable elsewhere.
Entitlements around Employment/ Education
You are legally required, if asked, to inform any potential employer of any long term condition during the recruitment process. Under the Employment Equality Act, the company cannot use your medical condition to discriminate against you in terms of successfully getting the job. Diabetes Ireland does not consider diabetes a disability nor do we consider it to have a substantial effect on any person’s ability to carry out normal day to day activities.
Diabetes Ireland advocates for equal rights for all workers with diabetes. Diabetes is legally viewed as a disability, because it is a disease that affects a “major life activity.” Recent court rulings have established that eating is a major life activity.
As a person with diabetes, you have certain rights. The right to eat food (either on the job, or to have a reasonable number of breaks to do so) is crucial for people with diabetes. People with diabetes also have the right to monitor their blood glucose, and administer insulin or medication accordingly. If you work in a public environment, you might ask to have a relatively private space in which to give yourself injections. People with diabetes also need freely available bathroom breaks. As a person with diabetes, you might also request to work regular hours, rather than shift work, if your doctor feels that your glucose control will be made more difficult with changing patterns. However, this is at the discretion of the employer.
A person with diabetes is entitled to time off to attend hospital appointments. However, payment for this time is at the discretion of the employer. Medical information is confidential, and so you do not need to share your medical past with your employer. You can share what you want, but you should also share what will be needed. The first step is to educate your employer. Explain what the effects of diabetes are and how diabetes can be managed. A person who manages their diabetes will not hold back any team. If anything, we suggest that a person with well-managed diabetes will be a benefit to their workplace, because they have learned organizational skills, self-discipline, and they lead a generally healthier lifestyle which results in fewer sick days.
Specific to Students and State Exams
When a person with diabetes is due to sit a state exam at post primary levels, they should inform the college or school that they may require to utilize the 2 ten minute rest breaks as per https://www.examinations.ie/schools/cs_view.php?q=fd8bb6c95031c7af7bc67154c68381c5656a4829 . Any person sitting the Leaving Certificate is advised to tick the box on the CAO form for the Disability Assess Route Education (DARE) which when submitted with a medical form (just stating you have Type 1 diabetes) permits access to college and automatically incurs extra benefits – reduced points for some courses and access to supports in college. See http://accesscollege.ie/dare/
This is a reasonable summary of entitlements for people with diabetes. However, if you have are aware of others Diabetes Ireland would like to hear from you. The information provided is for guidance only, please refer to the official site for full details.
Helpful Resources
www.revenue.ie
www.welfare.ie
For help with accessing information see http://www.citizensinformation.ie/en/
Updated: January 2020