Can I get tax relief on my Subscriptions?
You are already receiving tax relief on your subscriptions but it is given at source by the Revenue Commissioners to the Society and has been since April 2001. It is referred to as “Tax Relief at source-TRS”.
Can I get tax relief on Medical Expenses incurred by me and that the society has refunded me on or partially refunded me on?
Income tax relief is available on Medical Expenses incurred by you and not refunded by the society or any other party. There is no relief on Routine Dental and Routine Optical expenditure. Your local Revenue Office will provide you with the detail of the benefit and the method of reclaiming same or visit www.revenue.ie. If you elect to register for PAYE Anytime you can file to reclaim for your medical & dental expenses online. It is a requirement to keep a copy of all your receipts if you are claiming medical relief form Revenue so please retain a copy prior to submitting to POMAS for benefit. If you require a Summary of Medical Expenses paid by POMAS on your behalf, so that you can calculate the level of medical expenses that have not been covered, we oblige the members with this service from May onwards when the Annual Claim Processing is completed.
This is a manual process of reviewing claims up to the year 2014, so it will take our administration staff some time to retrieve all the details.
What expenses must I hold for my Annual Claim?
Your Annual Claim should include Doctor (GP) visits, all Out-Patient Consultant visits, and Dental and Orthodontic treatment for dependents up to the age of 18. To avoid unnecessary delays in processing your Annual Claim please ensures that all Dental Receipts are fully itemised and are clearly marked paid. Dental Charts must accompany both routine and non-routine Dental Claims. Dental Charts can be downloaded from our website under the Forms Section.
What am I entitled to if I go to my dentist and get an examination & scale & polish?
The Society continues to cover “scale & polish” treatments- up to 2 treatments per year per family member. The benefit applicable is €25 per “scale & polish”.
What am I entitled to if I go to my optician and get an examination & glasses or lenses?
The Society covers eye examination – Maximum of €15 and 90% of the cost of glasses or lenses up to a maximum of €160. The benefit is available to a child dependant each year up to the age of 18 years and to each Adult over 18 years every 2 years.
I have a child who is over 18, can they remain on cover?
Children of the Member including adopted/fostered/step children can remain on your policy until they reach their 26th birthday. Discounts on the adult premium will apply to young adults from June the 1st 2015 in line with the terms of the Health Insurance (Amendment) Act 2014 which has been adopted in full by the Committee of the Society. A sliding scale of subscriptions applies from the age of 21 to the age of 26.
The child rate is still effective up until they reach their 21st birthday.
When can I add a new-born child to my cover?
New-born/adopted/fostered children are covered immediately provided they are enrolled with the Society within 13 weeks of birth and appropriate subscription paid.
I am going into hospital will I be covered in a Private Room?
The Society provides cover for Semi Private Room only in all Hospitals in the State. Restrictions apply to the Mater Private & the Blackrock Clinic if it is non Cancer (Oncology) /Heart (Cardiac) in-stay hospitalisation. Please refer to the Benefit Brochure for more detail on Hospital Care.
Do we provide Travel Insurance?
No. You are strongly advised to acquire Travel insurance when going abroad.
If I go abroad for a procedure will it be covered?
No. If you go abroad to get a procedure carried out that is not available in Ireland, the HSE is obliged to cover it under your PRSI cover.
I recently sent in a claim where is my payment?
All Regular Claims are processed on average in a 5 day turn-round.
All annual Claims take approximately 6 weeks from date of receipt and are processed in the period on a receipt date basis.
All Hospital /Consultant Claims for in-stay hospitalisation, if all the paperwork is in order and a completed treating consultant form is received will be processed on a monthly basis.
If you change your bank account it is important that you supply your new IBAN & BIC code to us. All electronic payments now require IBAN & BIC Codes.
I sent in my claim form and it was returned to me for completion.
Most Claims are returned for the following reasons-
- The Member has not signed the Claim Form. Claim forms must be signed by the Serving Prison Officer Member or the Retired Member not a member of their family-(Unless prior agreement in exceptional circumstances is approved).
- All sections in Part B are not fully ticked.
- The Invoice/Receipt is not fully itemised. We are unable to assess the claim properly.
I am retiring from the Prison Service – What do I need to do to keep my cover with the medical aid Society?
Once you know the date you are retiring, you should inform us. It will take 8-10 weeks approx. to set up your deductions from your pension. In the meantime there will be an 8-10 week period when you will have to forward payment directly to the office. We will advise you of this amount when we send out the retirement forms for completion and you can return this amount together with the forms.
I or my Spouse/Partner does not hold Medical Insurance up-to joining POMAS. What “Waiting Period” applies before I can make a claim?
Initial Waiting Period.
An initial waiting period from the date the contract commences during which no benefit is payable, will apply to all new entrants to the Society, who do not currently hold or held within the previous thirteen weeks a private health insurance contract with a licensed medical insurer within the State as follows;
- New Member Initial Waiting Period of 26 weeks.
- Maternity Cover Initial Waiting Period of 52 weeks.
- New Born/Adopted Child Covered providing he/she is named on the policy and appropriate subscription is paid.
Cover for an accident or injury will be provided immediately where a person is named as an insured person on the policy.
Pre-existing Condition Waiting Period.
A pre-existing condition waiting period of five (5) years from the date the contract commences during which no benefit is payable, will apply to all new entrants to the Society, who do not currently hold or held within the previous thirteen weeks a private health insurance contract with a licensed medical insurer within the State. A pre-existing condition means an ailment, illness or condition, the signs or symptoms of which existed at any time in the six month period prior to becoming a new entrant to the Society. Medical insurance cover for that particular ailment, illness or condition will only commence after five years of continuous health insurance cover.
I am moving to POMAS Health-Cover from another provider and or my Spouse/Partner is moving to POMAS from another Provider. Do all POMAS Benefits apply to me immediately?
POMAS offers a comprehensive level of cover for everyday medical expenses – moving from some of the main providers may mean that you are upgrading your policy. In this instance you may be upgrading your cover.
On transferring from another medical insurer a “waiting period” of two years will apply to any enhanced inpatient hospital benefits or enhanced health services provided by the Society over and above that provided under your previous medical insurance contract.
I am joining POMAS after May 1st. Will Lifetime Community Rating apply to me?
Age at Entry Loadings.
Life time community rating will penalise those who leave it until later in life to take out Health Insurance Cover.
The age at entry loadings as set in statutory instrument number 312 of 2014 applies a 2% loading for each year by which a members age exceeds 34 years subject to a maximum loading of 70% at 69+ years of age. This Loading will apply for any person taking out health insurance for the first time from May 1st. Credited periods will apply which will reduce a person’s age at entry where that person had health insurance previously or were in receipt of a relevant Social Welfare payment as provided for in the statutory instrument.
Full details of our Benefits and Rules can be downloaded here.