Entitlement to free prescriptions?

pmlindyloo

Question on another forum............

I am on ESA in the support group and get £127.15 per week but get £17.18 taken off per week due to a small pension I have.

My letter says my income related amount is £109.97 but as I am entitled to Contributions based ESA I get £110.75 per week.

So claimant assessed for income based ESA and award shows support group component plus Enhanced disability premium (£127.15 per week) but pension of £17.18 deducted leaving £109.97 per week.

As the claimant is entitled to contribution based ESA of £110.75 per week they are paid this.

So does that mean that there is no entitlement to free prescriptions or there is?

If there is then does that mean that someone on contribution based ESA support group but not eligible for any premiums but has no savings/other income should complete an ESA3 to show their income based entitlement (which would be the same amount of money)allowing them to claim free prescriptions?

Anyone had experience of this?

huckster

https://www.nhsbsa.nhs.uk/nhs-low-income-scheme

Would need to apply under the NHS low income scheme.

Cpt.Scarlet

The rule is simple, they aren't receiving Income Related ESA so there is no entitlement to the passported benefits and will have to apply based on low income

pmduk

pmlindyloo wrote: »

If there is then does that mean that someone on contribution based ESA support group but not eligible for any premiums but has no savings/other income should complete an ESA3 to show their income based entitlement (which would be the same amount of money)allowing them to claim free prescriptions?

The method of claiming under the Low Income Scheme is to complete a Form HC1 and submit it to the NHSBSA in Newcastle.

Ames

pmduk wrote: »

The method of claiming under the Low Income Scheme is to complete a Form HC1 and submit it to the NHSBSA in Newcastle.

It's also a very fast process, turnaround in less than a couple of weeks.

If you need a prescription in this time I think you can reclaim the cost.

KxMx

The official turnaround time is up to 18 working days.
I've had claims come in at the end of that time scale myself

Cpt.Scarlet

N's logic is seriously flawed, if you follow it to it's logical conclusion then everybody on ESA(CB) is entitled to free prescriptions as you can always calculate an ESA(IR) amount, it's just not payable.

The documents that he is referencing do not define the legal requirement and it is an error to use the wording to support his argument.

pmlindyloo

Thanks everyone for your responses.

I am inclining towards it being a contribution based claim with no direct entitlement to free prescriptions etc

I have found this:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/658302/dmgch44.pdf

44045 - 44049

which explains about when you are eligible for both and how it is worked out.

I think 44049 supports the argument that it is a contribution based claim?

TELLIT01

Doesn't the section of the prescription form which the customer has to tick and sign refer to 'being in receipt of ......' to qualify? If somebody has an underlying entitlement they are not 'in receipt'.

Since posting I've found this which again refers to 'receiving' xyz benefit. So in the situation outlined in the OP I don't think they would be exempt from charges.

http://psnc.org.uk/dispensing-supply/receiving-a-prescription/patient-charges/exemptions/

pmduk

TELLIT01 wrote: »

Doesn't the section of the prescription form which the customer has to tick and sign refer to 'being in receipt of ......' to qualify? If somebody has an underlying entitlement they are not 'in receipt'.

Yes, the relevant box here is the box "in receipt of income-related employment and support allowance". Obviously, the only legally correct answer is no, hence the need to claim under the LIS.

Ames

One other thing to check is if they have an illness that gives an exemption from prescription costs. If they do then all prescriptions are free, not just ones for that condition. It's a form the GP surgery has to fill in.