Health minister Eddie Teare says front-line services may have to be cut, unless an extra ?8.5 million is granted to his department at next week's sitting of Tynwald.
The DHSS has released a breakdown of its overspend, showing exactly where the financial holes are which need plugging.
Three-and-a-half million pounds is required to meet obligations derived from a three per cent pay award to NHS and Whitley Council workers.
An extra ?2 million must be found for the next financial year to meet the ever-rising costs of Manx patients going to the UK for elective treatment.
The remaining ?3 million is split equally three ways to cover the cost of the swine flu response, an increase in benefits claims and a shortfall in National Insurance receipts.
Health Minister Eddie Teare says the causes of the overspend couldn't have been foreseen when their last budget was planned.
He says the department can't absorb it and the extra money is needed to maintain current levels of service.
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