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

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Ianb
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A question to tag onto the end of this discussion:

NHS website says:
“Eligibility criteria You qualify if, on the date you claim help with health costs:
a) you receive Universal Credit and either had no earnings or had net earnings of £435 or less in your last Universal Credit assessment period
or
b) you receive Universal Credit, which includes an element for a child, or you (or your partner) had limited capability for work (LCW) or limited capability for work and work-related activity (LCWRA), and you either had no earnings or net earnings of £935 or less in your last Universal Credit assessment period.”

Because this refers to ‘earnings’ I infer that unearned income (such as a pension) is ignored but I am nervous (paranoid) that the NHS wording may just have been badly written. Can anybody confirm whether when the NHS say ‘earnings’ that is what they mean in UC speak.

Does seem unfair that if unearned income is ignored someone with pension income might qualify for free prescriptions whereas someone with the same earned income would not. (I realise that this does not affect people living in Wales or Scotland or groups such as the over 60 who qualify for free prescriptions in England anyway.)

Daphne
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tbidmead
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Coming across one of these penalty charge notices for the first time today…

If a client has two dental appointments a week apart (attracting a single band 3 charge) but their assessment period starting & ending falls within the middle of these appointments as follows;

-Assessment period 1 ends - earnings below £435
-1st dental appointment
-Assessment period 2 ends - earnings above £435
-2nd dental appointment

I believe the client would be entitled to full remission on the basis that the ‘charge’ was ‘made’ on the date of the 1st appointment.

Would anybody suggest otherwise?

Ianb
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Macmillan benefits team, Citizens Advice Bristol

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Daphne - 03 January 2019 01:41 PM

It is earnings not income - see https://www.rightsnet.org.uk/welfare-rights/news/item/new-earnings-thresholds-introduced-in-universal-credit-to-establish-entitle

Thanks Daphne. Worrying unnecessarily on my part!
Sounds daft but would be clearer if the NHS guidance actually said earned income rather than earnings because the terminology would then match.

Has also been pointed out to me, by someone who cannot post here, that the ignoring of unearned income is not unfair given that a claimants with the same amount of earned income as someone with earned income will be getting less UC because of the different way they are treated within UC.

Happy New Year to you.

Daphne
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tbidmead - 03 January 2019 02:26 PM

Coming across one of these penalty charge notices for the first time today…

If a client has two dental appointments a week apart (attracting a single band 3 charge) but their assessment period starting & ending falls within the middle of these appointments as follows;

-Assessment period 1 ends - earnings below £435
-1st dental appointment
-Assessment period 2 ends - earnings above £435
-2nd dental appointment

I believe the client would be entitled to full remission on the basis that the ‘charge’ was ‘made’ on the date of the 1st appointment.

Would anybody suggest otherwise?

I agree Tom - but it would be harsh if it were the other way round!

tbidmead
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Daphne - 03 January 2019 03:22 PM
tbidmead - 03 January 2019 02:26 PM

Coming across one of these penalty charge notices for the first time today…

If a client has two dental appointments a week apart (attracting a single band 3 charge) but their assessment period starting & ending falls within the middle of these appointments as follows;

-Assessment period 1 ends - earnings below £435
-1st dental appointment
-Assessment period 2 ends - earnings above £435
-2nd dental appointment

I believe the client would be entitled to full remission on the basis that the ‘charge’ was ‘made’ on the date of the 1st appointment.

Would anybody suggest otherwise?

I agree Tom - but it would be harsh if it were the other way round!

Indeed - seeing this example definitely makes me agree with Andrew’s earlier comment re: encouraging all to complete HC1 applications.

Daphne
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Written answer yesterday questioning how claimants are ment to know they should tick the income-based JSA box says that it’s been widely advertised and, reassuringly, that -

Arrangements have also been made to ensure that if UC claimants accidentally tick the wrong box on the FP10 prescription form but can prove their eligibility for free NHS prescriptions, the NHS Business Services Authority is able to waive associated penalty charges upon being contacted.

Good of them to refund a penalty caused by their own ineptness is failing to amend the FP10 form!!! And provided the claimant contacts them!!!

Peter Turville
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Daphne - 23 January 2019 12:22 PM

Written answer yesterday questioning how claimants are ment to know they should tick the income-based JSA box says that it’s been widely advertised and, reassuringly, that -

Arrangements have also been made to ensure that if UC claimants accidentally tick the wrong box on the FP10 prescription form but can prove their eligibility for free NHS prescriptions, the NHS Business Services Authority is able to waive associated penalty charges upon being contacted.

Good of them to refund a penalty caused by their own ineptness is failing to amend the FP10 form!!! And provided the claimant contacts them!!!

And the only if the BSA will actually accept (understand) the evidence of eligibility provided - see my post of 6/6/18 above!

Andrew Dutton
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Still no explanation as to why it should be IBJSA and not any other?  Some clients fear fraud action as they are not jobseekers.


Yet another reason why UC is not ready, by a long chalk.

Peter Turville
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Andrew Dutton - 23 January 2019 01:30 PM

Still no explanation as to why it should be IBJSA and not any other?  Some clients fear fraud action as they are not jobseekers.

Why JSA-IB was not explained in the detailed response we received (see post 15 - 10/8/18) having specifically asked why the BSA were requiring patients to make a false declaration. Perhaps JSA-IB was where the dart landed?

As JSA & ESA are managed on the same IT system I really can’t see what difference it makes - if BSA actually checked with DWP it would show no award of either (or IS for that matter) let alone UC. So if the patient’s declaration was picked for a test check BSA would be none the wiser and still not able to check whether the claimant was eligible for exemption due to UC. The only way they can check is to request evidence from the patient of UC eligibility that provides the exemption.

Even when they add a UC box they still won’t be able to check exemption with DWP as they have no contract / method to this. So they will still have to request the patient provides the evidence when they undertake an eligibility for exemption check.

Our bureaucracy correspondent Mr Kafka provides the following analysis ........

shawn mach
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In the Guardian over the weekend:

... low-income patients on universal credit who are exempted from prescription charges are receiving penalty notices because prescription forms have not been amended to include the benefit – six years after it was introduced. Some have reported receiving multiple charge notices.

The NHSBSA says a universal credit tick box should be added “later this year”. Until then, claimants entitled to free prescriptions must tick the “income-based jobseeker’s allowance” box, but some who did so report they have still been penalised.

Call for action, as NHS accuses patients of prescription ‘fraud’

shawn mach
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Just checked nhs.uk that confims that:

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 ...

‘Interestingly’ they also say that, for ‘answers to your questions about help with health costs’, you should -

Follow the NHS Business Services Authority (BSA) on Facebook or Twitter ...

https://www.nhs.uk/using-the-nhs/help-with-health-costs/help-with-health-costs-for-people-getting-universal-credit/

The CASA
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Has anybody come across a a DWP letter sent to a small businesses, which demands information about a real person, which the business suspects,  but not an employee?It threatens prosecution of the business but is contradictory. . The letter includes “form EQ1 07/06.”, which is strange in itself having not been updated for over 10 years.

Ruth_T
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This is puzzling.  Form EQ1 is a “Statement of Earnings” form sent to employers when making enquiries about an employee.  They are most commonly used in fraud enquiries, but I’ve recently seen one used to collect information regarding dates of employment and earnings for a client in relation to a Right to Reside decision.

shawn mach
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New NAO report: Investigation into penalty charge notices in healthcare ... includes -

NHSBSA accepts that the rules around entitlement are complicated and recognises that genuine mistakes and confusion happen. The entitlements to free prescriptions and dental treatment are set by the Department. Factors which may cause mistakes and confusion include:

• Universal Credit claimants are only eligible for exemptions if their monthly earnings are below a specified level. Additionally, there is no option to indicate receipt of Universal Credit on NHS prescription forms. The Department expects to update the paper version of the prescription form in late 2019.

https://www.nao.org.uk/report/investigation-into-healthcare-penalty-charge-notices/