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UC & NHS charges exemption - NHS BSA doesn’t understand UC?

 

Peter Turville
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We are all familiar with the problems with exemption and ESA-IB & ESA-C and confusing ESA award notices. Latest from the NHS Business Services Authority. Client was on ESA-IB and then UC (lone parent with LCFW and no earnings).

“The award notice you sent shows the client did not meet [any of the] conditions, so she was not entitled to claim free NHS prescriptions.”

Client met every criteria for exemption!

How many other claimants are receiving penalty charges because the BSA do not understand UC payment notices (or info. from DWP they can access)?

Issue raised with clients MP.

     
ClairemHodgson
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it’s more a case of UC hasn’t been added to the form (and links to similar issues round free school meals).  MP’s need to raise it, of course, and it’s yet another (? unintended or intended?) consequence of UC being NFFP

     
Daphne
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We raised the lack of a box for UC on the prescription forms at stakeholders forum again yesterday for what it’s worth…

     
Phil R
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Daphne - 06 June 2018 10:12 AM

We raised the lack of a box for UC on the prescription forms at stakeholders forum again yesterday for what it’s worth…

This was an issue when I worked in Ashton JC in 2013 on the pilot. 5 years later and no change.

     
Peter Turville
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In our case the issue is not the lack of an appropriate tick box on the prescription (which arguably is pointless without info. on the actual qualifying criteria for a person receiving UC) but the BSA having been provided with clear evidence that the client met (all of the possible) criteria still determining that she did not! The only evidence a claimant can provide to the BSA is the relevant UC payment statement.

Maybe the issue is that older versions of the payment statement did not include info about exemption from NHS charges etc.  whereas the current version does. But it still does not state that the individual is eligible so BSA would still have to undertand the full statement to check eligibility.

      [ Edited: 6 Jun 2018 at 02:00 pm by Peter Turville ]
AMuller
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I had to check UC and prescription charges for a client and found the NHS website rather confusing.

The prescription page has a link to a UC page:  https://www.nhs.uk/NHSEngland/Healthcosts/Pages/universal-credit.aspx 

It says there that you should present your award notice but then it also seems to suggest that you should tick a box for Income based JSA:

“You should present a copy of your Universal Credit award notice to prove your entitlement. You’ll need to have met the eligibility criteria in the last completed Universal Credit assessment period before your health costs arose.”

” Not all help with health costs claim forms have a tick box for Universal Credit. If that’s the case, you should tick the box for income-based Jobseeker’s Allowance instead.”

I don’t know what the pharmacist is supposed to do when processing the prescription, but unless they have to add some information about having seen the UC award, ticking a JSA box when in receipt of UC does not sound a good idea to me

 

     
Mike Hughes
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I hadn’t really twigged to this before but does this means that someone who slips on and off UC thanks to the vagaries of either payment dates or income changes could be faced with the prospect of being able to claim prescription exemption one month but not the next?

I am of course assuming they get the topic of this thread correct but in the context of https://www.theguardian.com/society/2018/mar/10/nhs-falsely-accuses-thousands-patients-prescription-fraud even that doesn’t seem especially likely.

     
Andyp5 Citizens Advice Bridport & District
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Mike Hughes - 13 June 2018 03:38 PM

I hadn’t really twigged to this before but does this means that someone who slips on and off UC thanks to the vagaries of either payment dates or income changes could be faced with the prospect of being able to claim prescription exemption one month but not the next?

I am of course assuming they get the topic of this thread correct but in the context of https://www.theguardian.com/society/2018/mar/10/nhs-falsely-accuses-thousands-patients-prescription-fraud even that doesn’t seem especially likely.

Looks that way, as with slipping in and out of the benefit cap from one assessment period to another.

See page 9 of the attached.

‘Help with Health Costs (Department for Health and Social
Care/NHS):
NHS implemented earnings thresholds for Help with Health Costs under Universal
Credit in December 2016. These are £935 per month for claimants with children or
limited capability for work, and £435 per month for all other claimants.
Claimants self-declare entitlement for Help with Health Costs, e.g. by ticking on the
back of the prescription form. UC is currently not included on the form and claimants
are advised to tick the box for income-based Jobseeker’s Allowance. DHSC plan to
introduce a UC box on the prescription form by the end of the year.
If they are not sure whether they meet the criteria, claimants should pay for their
health costs and can claim a refund once they confirm entitlement’.

 

     

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Jon (CHDCA)
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Welfare Benefits, Craven CAB, N Yorks

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For free school meals, there’s some convoluted way of looking at UC passporting over 3 assessment periods rather than one. I wonder if something similar might work for prescriptions, to smooth out entitlement?

Ref: https://www.rightsnet.org.uk/forums/viewthread/12459/

     
Mike Hughes
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“If they are not sure whether they meet the criteria, claimants should pay for their health costs and can claim a refund once they confirm entitlement”.

Yes sirree, people will be queuing up for that option!