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Free prescriptions on ESA

carm

Hi I'm Carm. I'm trying to find out about prescription exemptions. My husband was on Incapacity Benefit years ago and was moved onto ESA so now gets Income Related and Contributions ESA. I'm finding it a bit of a minefield to find out whether he/we will get free prescriptions now that we will lose the child tax credits as our daughter has left full time education. He has diabetes and can I should think able to claim medical exemption on those grounds as he needs medication for it, However as I understand it, he will have to pay towards dental treatment etc. We have no savings whatsoever. So should we apply via HC1. I have had no clear answers as to which is our best option. P.ease help!

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Cher_Alumni

Hi @carm and a warm welcome to our community. How are you today?

Just to let you know, I've removed your duplicate post so we can keep all responses to you on this one thread

You can complete this online NHS 'Check if you're eligible for help' form to find out your eligibility for help with prescription/health care costs and what to do. I can relate to it feeling confusing!

I hope that helps but please give us a shout if you have any more questions.

carm

Thank you
Yes I'm fine thanks. Yes I realise about some medical exemptions and I did do that elible for help form, according to that he should be exempt under diabetes but as I understand it . A medical exemption for prescriptions only covers prescriptions not dental or travel to hospital appointments etc. It would only cover him too not myself. I would have to apply separately under low income. As I said we have no savings at all. However I was wondering if as he already gets income related ESA as well as contributions ESA does he qualify anyway because of being on income related? No one can give me a straight answer to that whoever I phone! The elible for help form on the NHS you can only tick either Incime related or contributions not both!

MarkM88

This link explains the eligibility for dental treatment, it does states that Income Based ESA is included, and since he has income and contribution based ESA I would imagine he would be eligible, however you may need clarification on that point.

Link - https://www.nhs.uk/nhs-services/dentists/dental-costs/get-help-with-dental-costs/

Again, its the same with the help towards travel costs, it states income based ESA so I'm assuming because part of the award is income based you are eligible, but again its worth getting clarification.

Link - https://www.nhs.uk/nhs-services/help-with-health-costs/healthcare-travel-costs-scheme-htcs/

MarkM88

In terms of Diabetes in relation to a Medical Exception Certificate, it only applies if -

diabetes insipidus and other forms of hypopituitarism
diabetes mellitus, except where treatment is by diet alone

Cher_Alumni

@carm Ah I see, as your husband gets income-related ESA he is entitled to help with health costs. See this Citizens Advice 'Help with health costs' webpage for everything that covers.

If you live together, then you'd be part of a joint claim meaning you would be entitled to the above too and wouldn't need to fill in a HC1 form.

I hope that helps. Please ask away with any other questions you might have.

calcotti

If he gets income based ESA he, and you, are exempt from prescription charges and entitled to free dental care etc.

carm

Thank you
This is the info I have already seen elsewhere, however when I was speaking on the phone to someone she directed me to claim via medical exemption for him due to diabetes, as he has contributions ESA, nowhere can I see if you get both income related AND contributions you can claim free prescriptions!
Also if he is entitled does he have to apply or will it automatically come through like the child tax prescription exemption certificate?
Why are things not straightforward these days lol!

calcotti

carm said:

Thank you
This is the info I have already seen elsewhere, however when I was speaking on the phone to someone she directed me to claim via medical exemption for him due to diabetes, as he has contributions ESA, nowhere can I see if you get both income related AND contributions you can claim free prescriptions!
Also if he is entitled does he have to apply or will it automatically come through like the child tax prescription exemption certificate?

If he receives income based ESA the exemption applies. From what you have posted he is receiving income based ESA. Other income etc is not relevant.
To take advantage of the exemption you tell the dentist (take the award letter with you to show them). For free prescriptions you complete the back of the prescription form and tick the relevant box. For travel cost you can sometimes get them reimbursed from a cashier's office in the hospital - again show the award letter, but if this is not available you have to apply within three months using form HC5(T) HC5(T).pdf (www.nhs.uk) and provide receipts.

carm

Thank you this what I was half thinking but couldn't get a definite answer on ( the contributions part confused people), so he or I wont have to reapply for any exemption certificate? At present we have a child tax prescription exemption which will run out in October now our daughter has left college.

Incidentally I had problems over that too, as the surgery which dispenses medications, refused to accept that as she has just turned 19 and finish college this year. However I was eventually able to find out she was still covered as we are still receiving child tax until end August also found the certificate is valid until October regardless as the change happened whilst the certificate was issued. I was finally reimbursed the £46. Odd I was charged for her prescription, ( several items)
Thank you again