Exemption Certificates / Help With Health Costs (Info)

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Exemption Certificate Criteria
How Exemption Certificates Are Issued
The Role Of HMRC
The Role Of The Prescription Pricing Authority

   Exemption Certificate Criteria

A family is entitled to receive an Exemption Certificate where they satisfy one of the three criteria below

• Criteria 1

• The family’s gross income is below the earnings threshold for the relevant tax year (see the Note below for the earnings threshold)

And

• The family is in receipt of WTC and CTC

And

• The family is not in receipt of IS, JSA(IB), ESA(IR) or PC

• Criteria 2

• The family's gross income is below the earnings threshold for the relevant tax year (see the Note below for the earnings threshold)

And

• The family is receiving WTC with a disability element

And

• The family is not in receipt of IS, JSA(IB), ESA(IR) or PC

• Criteria 3

• The family's gross income is below the earnings threshold for the relevant tax year (see the Note below for the earnings threshold)

And

• The family is receiving CTC only

And

• The family is not in receipt of IS, JSA(IB), ESA(IR) or PC

Note: Each tax year the earnings threshold may change. The details of the earnings thresholds for the previous, the current and the next tax years are

2003 / 2004 - £14,200

2004 / 2005 - £14,600

2005 / 2006 - £15,050

2006 / 2007 - £15,050

2007 / 2008 - £15,050

2008 / 2009 - £15,050

2009 / 2010 - £15,276

  How Exemption Certificates Are Issued

HM Revenue & Customs (HMRC) provides the Prescription Pricing Authority (PPA), which is part of the Department of Health (DoH) with details of all families who are entitled to help with health costs.

The details that are passed to the PPA are

• Claimant(s) NINO

• Claimant(s) title

• Claimant(s) forename and surname

• Claimant(s) address

And

• Child(s) details - surname, forenames, and date of birth

This information is passed to the PPA on a monthly basis around the 6th of each month.

It should take no more than 8 weeks, from the date HMRC process the tax credits claim to the date the claimant receives their Exemption Certificate from the PPA.

Note: If the personal details for the claimant(s) and child(ren) are not in the correct format, their data will be rejected by PPA and the family will not receive an exemption certificate. The claimant’s details will be sent back to HMRC for correction. Once the details have been corrected by HMRC, the claimant's details will be selected on the next monthly extract

Once correct data has been passed to the PPA, it is then their responsibility to issue the Exemption Certificate.

Note: The PPA does not have any facility to amend or change the claimant’s details. The PPA does not hold, or have access to any other claimant details other than those stated above

Where the claimant contacts the PPA regarding their entitlement to an Exemption Certificate or to report a change of circumstances, the claimant will be told to contact HMRC.

   The Role Of HMRC

HMRC staff will receive telephone calls and correspondence from claimants regarding exemption certificates. HMRC is responsible for dealing with the following queries

• Change of name

• Change of address

• Change to the children in a family

• A death in the family

• Entitlement to an exemption certificate

This list is not exhaustive

HMRC identifies those families who satisfy the Exemption Certificate Criteria and passes that information around the 6th of every month to the PPA.

HMRC should only refer callers back to the PPA in the following circumstance

• The operator has checked with the claimant that all the personal details and circumstances that are recorded on the tax credits computer are correct. The personal details must be in the correct format, otherwise they will be rejected by PPA (see below)

And

• The operator has checked and established that entitlement to an Exemption Certificate exists (the family satisfies one of the Exemption Certificate Criteria above)

And

• The operator has checked that 8 weeks has passed since the award that entitled the family to an Exemption Certificate was issued

Note: If all the steps above have not been followed, for example, 8 weeks has not passed, there is nothing the PPA can do for the claimant and the claimant will be directed back to HMRC

Where the claimant is entitled to receive an Exemption Certificate but they have not yet received it, the claimant is able to use their tax credits award notice as proof of entitlement.

Rejected Data - Any data that is rejected by the PPA will be returned to HMRC to be corrected. Data will be rejected in the following circumstances

• There is no title for the claimant(s)

• The title is not in the correct format, for example, Mr, Miss, Mrs, Rev

• There are spaces in the title, for example, M r, Mi ss

• There is no forename

• There is no surname

• The surname is , for example, entered as ‘To be issued manually’ instead of the claimants correct surname ‘Smith’

• The postcode is not in the correct format

• The address is , for example, entered as ‘To be issued manually’ instead of the claimants full address ’21 The St, Blackpool, FY2 1AA

• The child’s name is , for example, entered as ‘Taylor – previously known as Sosa’ instead of the child’s correct surname ‘Taylor’

• There are duplicate children on the record and neither have a Responsibility End Date

  The Role Of The Prescription Pricing Authority

The PPA is part of the DoH and it is their responsibility to issue Exemption Certificates to tax credits claimants whose details have been passed over by HMRC. These claimants will have satisfied one of the Exemption Certificate Criteria.

Note: It is not the responsibility of the PPA to answer queries about whether claimants satisfy the above Exemption Certificate Criteria. Claimants telephoning the PPA will be advised whether an Exemption Certificate has been issued to them and be given advice on how to use the Exemption Certificate

It is the responsibility of HMRC to answer queries about whether claimants satisfy the Exemption Certificate Criteria and ensure that tax credits data is correct and reflects the claimant’s current circumstances.

The PPA does not have access to the tax credits computer and they are not able to amend or change any data passed to them by HMRC.

If the PPA do not have any record of the claimant on their database, then either

• The details on the tax credits computer for the claimant may be incorrect and they do not satisfy the Exemption Certificate Criteria

• Less than 8 weeks has passed since the award was issued which entitled the claimant to receive an Exemption Certificate

Or

• PPA has rejected the claimant's details, as the personal details are not in the correct format (see The Role Of HMRC Rejected Data above)