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IB ESA (NI Conts only) & Free Prescriptions
This probably been addressed before but can I confirm that where a person is in a couple and is is too ill to work they can claim their NI Conts only on ESA when their partner is on an income in excess of their applicable amount. Secondly can this person who just gets their NI Conts paid via ESA still claim free NHS prescriptions or do they have to actually be in receipt of the ESA assessment rate or WRAC or SG to qualify for the prescriptions.
..where a person is in a couple and is is too ill to work they can claim their NI Conts only on ESA when their partner is on an income in excess of their applicable amount.
I’m not sure if I understand your question. If he applies for ESA and provides a sick note then provided he hasn’t had any negative WCA’s previously he could expect to be treated as having LCW until undergoing a WCA. If he satisfies the ESA means-test and/or the ESA contribution conditions, he could be paid contributory and/or income-related ESA. If his partner’s earnings aren’t over his applicable amount (which would include the personal allowance for a couple, ie £114.85 p/w) then he’d normally qualify for ir-ESA unless there’s some other reason preventing entitlement.
I’m assuming from your question that there is such a reason, eg capital, otherwise why would you be asking about “credits only”. For the same reason I’m assuming that he is not entitled to contributory ESA for which his partner’s earnings would be irrelevant. In which case, he could qualify for credits if he could show that he would have had LCW had he satisfied the contribution conditions. How does he show that? Exactly the same way as above, ie claim ESA despite the fact he won’t qualify for it, provide a sick note and have no previous negative WCAs (unless he can show worsening etc) followed by passing the WCA.
..Secondly can this person who just gets their NI Conts paid via ESA still claim free NHS prescriptions or do they have to actually be in receipt of the ESA assessment rate or WRAC or SG to qualify for the prescriptions.
To be in one of the groups exempt from charges I think they have to be in receipt of ESA proper,rather than have an award of LCW credits.
FAO Tom - Client has not paid in any NI contributions for years and partner’s income is in excess of app amount. So client can get his/her NI conts started up again if passing the WCA but are you saying he/she still won’t be eligible for free prescriptions unless actually in receipt of the WRAC or SG element.
It’s not the WRAC/SC that the issue, it’s Income Related ESA that passports you to no health costs. They could apply for an HC3 Certificate (partial help) by filling in an HC1 form - order here - https://apps.nhsbsa.nhs.uk/LISWebAppStaticData/begin.do if their disposable income is low enough.
http://www.nhs.uk/NHSEngland/Healthcosts/Pages/nhs-low-income-scheme.aspx and links for further info
Your client won’t automatically qualify for free prescriptions if he has no entitlement to IB ESA and if he ticks the box on his prescriptions to state otherwise he is at risk of being hauled over the coals for it . He might, however, have a condition that would result in exemption from prescription charges- A ‘continuing physical disability’ that results in him needing assistance to leave the house for example. If so, he can pick up an exemption form from his local surgery (FP92A). If you have a copy of the Disability Rights Handbook see page 291 for more details of who can be exempt.
Many thanks 1964 but unfortunately the client suffers from mental health issues only. But again if the client receives NI CONTS only because he/she is too ill to work and because of partner’s income, is this enough to receive free prescriptions or do they have to actually be in receipt of ESA payments.
Many thanks 1964 but unfortunately the client suffers from mental health issues only. But again if the client receives NI CONTS only because he/she is too ill to work and because of partner’s income, is this enough to receive free prescriptions or do they have to actually be in receipt of ESA payments.
They have to be in receipt of IBESA.
Think about it; if conts only passported to free health costs a family with a six figure income might still qualify; that would be perverse.