The existing Regulations setting the age of exemption for prescription and dental charges are not currently linked to state pension age, which stands at 65 for men and 61 for women. For both men and women, age related exemption from prescriptions is currently set at 60, whilst age related exemption from dental charges is currently set at 65. Since 2010 the state pension age for women has been gradually increasing from 60, and will reach 65 by 2018, with an increase for both men and women to age 66 between 2018 and 2020. The Regulations, if approved by Tynwald, would streamline the existing system so that future changes to state pension age are automatically mirrored, ensuring that the exemption from charges is in line with other benefits and therefore more equitable. This means that those who are still of working age and who are therefore more likely to be able to afford the Island’s modest subsidised prescription and dental charges pay; whilst ensuring that those of state pension age, who are more likely to struggle to meet the costs associated with dental care and prescriptions are exempt from paying them. There could also be future changes as Government considers taking into account people’s ability to pay via methods such as means testing.
The amended Regulations would mean that women aged 60, and men aged 60 - 64 would no longer be eligible for free prescriptions, instead qualifying for exemption from these charges at state pension age - 61 and 65 respectively. As the age for exemption from dental charges is currently set higher than those for prescription charges – 65 instead of 60, women aged 61 – 64 would benefit from exemption from dental charges.
As the state pension age increases for women over the next five years, the exemption ages will align by 2018 to 65 for both men and women and then 66 by 2020. The changes would see an increase in income for the Department from prescription charges, but for a period of five years there would be a decrease in income for dental charges. In the short term the changes will likely be cost neutral, with one offsetting the other. In the longer term, whilst these changes would reduce the future overall burden on the Department’s budget for dental treatments and prescriptions for those of working age, changes to state pension age is a result of longer life expectancies, and as such any savings would likely be utilised to help fund exemptions which are lasting longer and costing more as people live longer into old age.
The Regulations will also lower the exemption age from those aged under 18 to those aged under 16, however those in full time education aged under 19 will still be exempt from dental charges.
The Minister said:
'If approved, in the long term these changes will provide a much fairer and equitable system, bringing these key age related benefits into line with state pension age and therefore with other state benefits. As the state pension age increases for women over the next five years to 65, we can bring equilibrium to the system with clear measures ensuring that exemption is solely focussed at those of state pension age where ability to pay may become more difficult. There are of course other exemption criteria to support those who are below state pension age but who are in a vulnerable group or who may struggle to pay. It’s also important to remember that both prescription and dental charges are heavily subsidised, remain relatively low cost, and are less in the Isle of Man than in England.'
Prescriptions in the Isle of Man are charged at £3.85 per item compared to £7.65 per item in England, with pre-payment certificates available for 4 months at £19 and 12 months at £54, which cover an unlimited number of prescriptions. Dental charges in the Isle of Man are between £16.50 and £198, whereas in England they range from between £17.50 and £209.
If approved, the Regulations will come into force on Saturday, 1 June 2013.
The National Health Service (Charges for Drugs and Appliances) (Amendment) Regulations 2013
The National Health Service (Dental Charges) (Amendment) Regulations 2013
