OpenLegislation

Regulation 8 Eligibility for a voucher — supply of optical appliances

England and Wales

(1)

A payment must be made as provided for by this Part to meet, or to contribute towards, the cost incurred (whether by way of a charge under the 2006 Act or otherwise) for the supply of an optical appliance for which a prescription has been given for an eligible person in consequence of a sight test (whether or not that sight test took place under the 2006 Act).

(2)

An eligible person is a person who at the time of the payment for the supply of the optical appliance is any of the following—

(a)

a person who is under the age of 16 years;

(b)

a person who is under the age of 19 years and receiving qualifying full-time education within the meaning of section 180(8) of the 2006 Act (payments in respect of costs of optical appliances and sight tests);

(c)

a person whose resources are treated, in accordance with paragraph (3), as being less than their requirements;

(d)

a person whose income resources, as calculated in accordance with Part 4 of, and Schedule 1 to, the Remission Regulations, exceed their requirements as so calculated, but whose patient contribution is less than the face value of a voucher issued to them under this Part, and whose capital resources as so calculated do not exceed the capital limit;

F1(da)

a person who is, for the purposes of regulation 5(1)(da) of the Remission Regulations (entitlement to full remission and payment), part of medical evacuation arrangements from a conflict zone;

(e)

a person for whom a prescription is issued for a complex appliance;

(f)

a prisoner;

F2(g)

a person for whom a prescription for the supply of an optical appliance is issued in consequence of a sight test in a special educational setting.

(3)

A person's resources must be treated as being less than their requirements if—

F3(a)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(b)

that person's income resources, as calculated in accordance with Part 4 of, and Schedule 1 to, the Remission Regulations, do not exceed their requirements as so calculated, or exceed their requirements by fifty per cent or less of the amount of the charge specified in regulation 3(1)(b) of F4the National Health Service (Charges for Drugs and Appliances) Regulations 2015 (supply of drugs and appliances by chemists), and their capital resources as so calculated do not exceed the capital limit;

(c)

that person is a member of the same family as a person described in sub-paragraph (b);

F5(d)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F6(e)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F7(f)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F8(g)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(h)

that person is receiving pension credit guarantee credit or is a member of the same family as a person who is receiving pension credit guarantee credit;

(i)

that person is in receipt of income-related employment and support allowance, or is a member of the same family as a person in receipt of income-related employment and support allowance; or

F9(j)

that person is a “relevant universal credit recipient.

F10(3A)

For the purposes of paragraph (3)(j) “relevant universal credit recipient” means a person who, in the relevant assessment period—

(a)

had an award of universal credit, either as a single claimant or as one of joint claimants, where—

(i)

the award did not include the child element,

(ii)

the single claimant or, as the case may be, both joint claimants, did not have limited capability for work, and

(iii)

the single claimant had earned income or, as the case may be, the joint claimants had combined earned income, of £435.00 or less;

(b)

had an award of universal credit, either as a single claimant or as one of joint claimants, where—

(i)

the award included the child element, and

(ii)

the single claimant had earned income or, as the case may be, the joint claimants had combined earned income, of £935.00 or less;

(c)

had an award of universal credit, either as a single claimant or as one of joint claimants, where—

(i)

the single claimant or, as the case may be, one or both joint claimants, had limited capability for work, and

(ii)

the single claimant had earned income or, as the case may be, the joint claimants had combined earned income, of £935.00 or less; or

(d)

was a qualifying young person for whom a recipient referred to in sub-paragraph (b) or (c) is responsible (within the meaning of Part 1 of the Welfare Reform Act 2012 (universal credit) and regulations made thereunder).

(3B)

Where paragraph (3C) applies, a person is to be treated as a person of a description specified in paragraph (2) for the purposes of regulation 24 (payments in respect of optical appliances).

(3C)

This paragraph applies where the conditions in sub-paragraphs (a), (b), (c) or (d) of paragraph (3A) are satisfied in the assessment period in which the supply of the optical appliance is paid for and—

(a)

there is no relevant assessment period; or

(b)

none of those conditions were satisfied in the relevant assessment period.

(4)

In paragraph (3), in—

(a)

sub-paragraphs F11... (c) and (h), “family” has the meaning given to it by section 137(1) of the Social Security Contributions and Benefits Act 1992 M1 (interpretation and supplementary provisions), as it F12applied to income support on 31st March 2026;

F13(b)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F14(c)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(d)

sub-paragraph (i), “family” has the meaning given to it by regulation 2 of the Employment and Support Allowance Regulations 2008 M2 (interpretation);

F15(e)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F16(4A)

For the purposes of paragraphs (3A) and (3C)—

  • “assessment period” means the assessment period for the purposes of universal credit as specified in regulation 21 of the Universal Credit Regulations 2013 (assessment periods);

  • “child element” means the child element of universal credit as specified in regulation 24(1) of the Universal Credit Regulations 2013 (the child element);

  • “earned income” means a person’s earned income as defined by Chapter 2 of Part 6 of the Universal Credit Regulations 2013 (calculation of capital and income - earned income);

  • “joint claimant” has the meaning given in section 40 of the Welfare Reform Act 2012 (interpretation of Part 1);

  • “limited capability for work” means limited capability for work or limited capability for work and work-related activity as construed in accordance with regulations 39 and 40 respectively of the Universal Credit Regulations 2013 (limited capability for work; limited capability for work and work-related activity);

  • “qualifying young person” has the meaning given in section 10(5) of the Welfare Reform Act 2012 (responsibility for children and young persons);

  • “relevant assessment period” means the assessment period immediately preceding that in which the supply of the optical appliance is paid for ;

  • “single claimant” has the meaning given in section 40 of the Welfare Reform Act 2012 (interpretation of Part 1); and

  • “universal credit” means universal credit under Part 1 of the Welfare Reform Act 2012 (universal credit).

(5)

For the purposes of regulation 10 and other provisions of this Part that apply to payments where the sight test was carried out by an NHS trust or NHS foundation trust, a person is also an eligible person if, because of the frequency with which the condition of their eyes changes, they are considered by the NHS Trust or NHS foundation trust to be non-tolerant of their existing optical appliance.

Annotations

Textual amendments

F1

Reg. 8(2)(da) inserted (1.12.2025) by The National Health Service (Help with Health Costs) (Miscellaneous Amendments) Regulations 2025 (S.I. 2025/1165), regs. 1(1), 4

F2

Reg. 8(2)(g) inserted (19.12.2024) by The National Health Service (Ophthalmic Services and Optical Charges and Payments) (Amendment) Regulations 2024 (S.I. 2024/1250), regs. 1(2), 4(3)

F3

Reg. 8(3)(a) omitted (15.4.2026) by virtue of The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(a)

F4

Words in reg. 8(3)(b) substituted (1.4.2015) by The National Health Service (Charges for Drugs and Appliances) Regulations 2015 (S.I. 2015/570), reg. 1, Sch. 2 para. 6

F5

Reg. 8(3)(d) omitted (15.4.2026) by virtue of The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(a)

F6

Reg. 8(3)(e) omitted (15.4.2026) by virtue of The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(a)

F7

Reg. 8(3)(f) omitted (15.4.2026) by virtue of The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(a)

F8

Reg. 8(3)(g) omitted (15.4.2026) by virtue of The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(a)

F9

Reg. 8(3)(j) substituted (1.11.2015) by The National Health Service (Exemptions from Charges, Payments and Remission of Charges) (Amendment and Transitional Provision) Regulations 2015 (S.I. 2015/1776), regs. 1(1), 4(a) (with reg. 7)

F10

Reg. 8(3A)-(3C) substituted for reg. 8(3A) (1.12.2016) by The National Health Service (Exemptions from Charges, Payments and Remission of Charges) (Amendment and Transitional Provisions) Regulations 2016 (S.I. 2016/1045), regs. 1(1), 4(2)(a) (with regs. 5, 6)

F11

Word in reg. 8(4)(a) omitted (15.4.2026) by virtue of The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(b)(i)(aa)

F12

Words in reg. 8(4)(a) substituted (15.4.2026) by The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(b)(i)(bb)

F13

Reg. 8(4)(b) omitted (15.4.2026) by virtue of The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(b)(ii)

F14

Reg. 8(4)(c) omitted (15.4.2026) by virtue of The National Health Service (Travel Expenses and Remission of Charges, Ophthalmic Services, and Optical Charges and Payments) (Amendment) Regulations 2026 (S.I. 2026/205), regs. 1(2), 3(3)(b)(ii)

F15

Reg. 8(4)(e) omitted (1.12.2016) by virtue of The National Health Service (Exemptions from Charges, Payments and Remission of Charges) (Amendment and Transitional Provisions) Regulations 2016 (S.I. 2016/1045), regs. 1(1), 4(2)(b) (with regs. 5, 6)

F16

Reg. 8(4A) inserted (1.12.2016) by The National Health Service (Exemptions from Charges, Payments and Remission of Charges) (Amendment and Transitional Provisions) Regulations 2016 (S.I. 2016/1045), regs. 1(1), 4(2)(c) (with regs. 5, 6)

Marginal citations

M1

The definition of ‘family’ in section 137(1) was amended by paragraph 46 of Schedule 24 to the Civil Partnership Act 2004 (c.33).

M2

S.I. 2008/794.