Universal Credit and Free Prescriptions – am I entitled?

Knowing if you’re entitled to free prescriptions as a claimant of Universal Credit is absolutely crucial, and can be a major burden off those who are receiving the benefit. So, the big question is – if you are claiming Universal Credit, are you entitled to free prescriptions? The short answer is: probably, but not definitely. Some of this depends on your own circumstances, rather than if you are in receipt of Universal Credit, and there are various benchmarks to judge whether you will or will not get free prescriptions through the NHS.

Do I get free prescriptions as a Universal Credit claimant?

If you need free prescriptions as someone who is being paid Universal Credit, you need to fit within one of the two following brackets, whether you receive Universal Credit as a single person, or you are claiming as a part of a couple.

  • for the last complete assessment period you and your partner (if you have one) had either no earnings or net earnings of £435.00 or less. Or;
  • for the last complete assessment period you and your partner (if you have one) had either no earnings or net earnings of £935.00 or less, and had a child element included in your award or had limited capability for work
    (You would also be entitled if you are a dependent child or qualifying young person of someone who meets the above criteria in the second paragraph)

The assessment period mentioned above relate to a full calendar month from the date of your last claim for Universal Credit, and between the same dates for each calendar month after that. The net earnings mentioned above relate to what is classed as your ‘take-home pay’ on your Universal Credit statement.

The Universal Credit statement can be used as proof for free prescriptions if you fall within the above criteria, but please be aware that it is your own responsibility before you attempt to claim any free prescriptions as a benefit claimant. If your prescription slip does not have the option to tick to say that you are receiving Universal Credit, you should check the box that says you are claiming for income-based Jobseekers Allowance (JSA).

Claims can only be made on your last universal Credit period, and you cannot claim free prescriptions simply if you are expecting to fall within the above boundaries during your next period. In this case, you would need to make payment for your prescriptions, and request what is called an FP57 receipt. this will allow you to claim a full refund if you do fall within the above qualifying boundaries within the Universal Credit assessment period during which you have made the payment.

The NHS website advises:

You should pay for any health costs if you’re unsure whether you meet the eligibility criteria. You can claim a refund once you’re able to confirm your entitlement.

This might be the case because:

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

You need to have met the eligibility criteria either in the Universal Credit period before you paid, or in the same assessment period in which you paid, to qualify for a refund.

Make sure you ask for and keep receipts. If you pay for a prescription, you must get a receipt and refund form (FP57) at the time you pay, as you won’t be able to get one later.

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