TCM0202120 - Passported benefits - exemption / health costs: Health costs refund (AG)

To deal with an enquiry from a customer who wishes to claim a refund for health charges, consider steps 1 to 8.

Step 1

If the customer is enquiring about

  • prescription charges, go to Step 2.
  • dental treatment, go to Step 4.
  • sight test, go to Step 4.
  • glasses, go to Step 4.
  • travel to hospital, go to Step 5.
  • wigs, go to Step 5.
  • fabric supports, go to Step 5.
  • not hearing from the NHS Business Services Authority (NHS BSA) regarding their refund, go to Step 8.

Step 2

Tell the customer that they will

  • need to provide
  • an NHS tax credit Exemption Certificate

or

  • pages 1 and 2 of the tax credit Health Service exemption form

Note: This can be a photocopy. However, it must be stamped and dated by the local office.

  • also need to complete the following form that they can obtain from the pharmacist when their prescription is dispensed. They can not get one later

form FP57 - England

form FP57 - Scotland

form PS7 - Northern Ireland

form WP57 - Wales

then

  • If the customer does not have form FP57, PS7 or WP57, go to Step 3.
  • If the customer does have form FP57, PS7 or WP57, go to Step 4.

Step 3

Tell the customer

  • they can not get a refund but there are arrangements in place for considering refund claims where form FP57, PS7 or WP57 is not produced (but only in exceptional circumstances)
  • if they think they have a good reason for not getting the official NHS receipt, they should submit a letter, explaining their reasons and enclosing any proof of payment - for example, a till receipt - and proof of the exemption to Review Section, NHS BSA, PO Box 993, Newcastle Upon Tyne, NE99 2TZ

Note: Not being aware that they should get form FP57, PS7 or WP57 is not a good reason. Form FP10 tells the customer about the receipt.

then

  • take no further action.

Step 4

Tell the customer that they should follow the instructions on form FP57, PS7or WP57 in order to claim a refund

Note: If the customer is claiming within three months of the purchase, form FP57, PS7or WP57 tells the customer to take the relevant evidence to the Post Office.

Note: If the customer is claiming after three months of the purchase, form FP57, PS7 or WP57 tells the customer that, if they think there were exceptional circumstances that prevented them from claiming within the three months, they should submit a letter. The letter should explain the reasons and the customer should enclose original receipts (and the optical prescription for glasses or contact lenses and proof of their exemption) and send to NHS BSA, PO Box 993, Newcastle Upon Tyne, NE99 2TZ.

  • take no further action.

Step 5

Tell the customer they will

  • need to provide
  • a NHS tax credit Exemption Certificate

or

  • pages 1 and 2 of the tax credit Health Service exemption form

Note: This can be a photocopy. However, it must be stamped and dated by the local office.

  • also need to complete form HC5 for dental treatment, sight test, glasses, travel to hospital, wigs or fabric support

Note: This form is available from Jobcentre Plus offices or NHS hospitals. Some dentists and opticians also stock them. Alternatively, the customer can phone 0845 850 11 66.

  • need to provide the original receipt (and the optical prescription if claiming for glasses or contact lenses).

Step 6

Tell the customer that they should send all the above documentation to NHS Business Services Authority, PO Box 1011, Newcastle Upon Tyne, NE99 2ZP.

Note: The NHS BSA will authorise the form HC5 and send it to the appropriate paying body for payment.

Step 7

Tell the customer that the NHS BSA will

  • aim to authorise the refund application within five working days of receiving the relevant documents
  • write to them telling them which paying body will issue their payment

then

  • take no further action.

Note: The paying body will process and issue the payment as soon as possible.

Step 8

Tell the customer that, if they have sent their documents to the NHS BSA and they have not heard anything after 15 days of posting it, they should contact the NHS BSA on 0845 609 9299.