Universal Credit claimants could receive help with NHS health costs – criteria explained

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Universal Credit claims can provide payments for varying living costs which can cover rent and childcare costs. Claimants may also be able to receive support for certain NHS health costs and treatments.

To qualify for this support, a person must be receiving Universal Credit and either had no earnings or had net earnings of £435 or less in their last assessment period.

Or, a person may also qualify if they receive Universal Credit, which includes an element for a child, or they (or their partner) had limited capability for work (LCW) or limited capability for work and work-related activity (LCWRA), and they either had no earnings or net earnings of £935 or less in their last assessment period.

If a claimant is part of a couple, the net earning threshold will apply to combined earnings.

When applying for the additional support, the claimant will need to present a copy of their Universal Credit award notice to prove their entitlement.

Additionally, the claimant will need to have met the NHS’s eligibility criteria during the last completed assessment period before the health costs arose.

Many of these health cost requests can be completed through claim forms which should have a tick box for Universal Credit.

In some instances however, a Universal Credit tick box will not be present and claimants should then tick the box for income-based Jobseeker’s Allowance instead.

If claimants are unsure if they’re eligible, the NHS detailed they should pay for the any health costs applicable and then claim a refund once entitlement can be confirmed.

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A person may be unsure of their eligibility due to the following examples:

  • Their Universal Credit claim is still being assessed
  • They’re waiting for a decision about a Universal Credit claim that might change the threshold that applies to them
  • They’re uncertain whether their earnings are within the threshold

To ensure a refund can be received in these circumstances, the claimant will need to have met the eligibility criteria either in the Universal Credit period before they paid, or in the same assessment period in which you paid.

Claimants should always remember to ask for and keep receipts to help with this.

If they pay for prescriptions, they must get a receipt and refund form (FP57) at the time they pay, as they will not be able to get one later.

Currently, there is an NHS Business Services Authority (BSA) on social media which can help with and answer questions on health costs.

To be eligible for Universal Credit initially, a person must be on a low income or out of work entirely.

They must also be aged between 18 and state pension age, although there are some exceptions for people aged 16 or 17.

Claimants must also not have more than £16,000 or more in savings which can be split with a partner.

Universal Credit payments are assessed on a monthly basis and as such, they can go up or down if a claimants earnings levels change regularly.

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