The Community Ophthalmic Services Scheme (COSS) is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians.
Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.
The Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013 (SI 274 of 2013) sets the fees for optometrists and dispensing opticians under the Community Optometric Services, Community Spectacle Dispensing Services and Health Amendment Act Card Schemes.
Increasing the fee payable to contractors for a standard eye examination under the COSS (to ensure parity with that payable for the same exam under the Department of Social Protection’s Treatment Benefit Scheme) is a priority for my Department, and work with stakeholders is ongoing in this regard.
The Department has also been meeting with Optometry Ireland to discuss the contribution that optometrists provide to our healthcare service and how this contribution could be further expanded.
There will be engagement between my Department and the Department of Public Expenditure, National Development Plan Delivery and Reform during the Estimates 2025 process in regard to the funding needed to progress healthcare priorities.
I believe that there is a real opportunity to work collaboratively with community optometrists, and with other healthcare providers, to make a significant difference to patient outcomes. Of course, any publicly funded ophthalmic service expansion should address unmet public healthcare needs and improve access to public health services while ensuring value for money.
