Northern Ireland has introduced a clear earnings test for Universal Credit claimants accessing Health Service support for optical costs, sight tests and travel charges. The Health and Social Care (Exemptions from Charges, Payments and Remission of Charges) (Amendment and Transitional Provision) Regulations (Northern Ireland) 2025 were made on 4 November 2025 and take effect on 1 December 2025. The instrument amends the Optical Charges and Payments Regulations (Northern Ireland) 1997, the Travelling Expenses and Remission of Charges Regulations (Northern Ireland) 2004, and the General Ophthalmic Services Regulations (Northern Ireland) 2007, as set out in S.R. 2025 No. 172.
At the centre of the changes is a new category of 'relevant universal credit recipient'. Eligibility turns on earned income in the Universal Credit assessment period. Claimants without the child element, LCW element or LCWRA element qualify at £435 or less. Claimants whose award includes any of those elements qualify at £935 or less. Where a person is responsible for a qualifying young person, that young person is also eligible on the £935 threshold basis.
The Regulations adopt Universal Credit terminology to avoid ambiguity. 'Assessment period', 'earned income', 'couple', 'single person', 'child element', 'LCW element', 'LCWRA element' and 'qualifying young person' take their meanings from the Welfare Reform (Northern Ireland) Order 2015 and the Universal Credit Regulations (Northern Ireland) 2016. The Department’s Explanatory Note confirms that earned income is considered exclusive of income tax, National Insurance contributions, pension contributions and welfare supplementary payments provided under the Fresh Start mitigation arrangements.
For optical support, regulation 8 of the 1997 Optical Charges Regulations now includes 'relevant universal credit recipient' among those eligible for payments by voucher towards the supply, replacement or repair of optical appliances. The instrument also updates interpretative provisions linked to legacy definitions of 'family' referenced in related social security legislation to maintain consistency in how household status is determined for eligibility.
For sight tests, regulation 16 of the General Ophthalmic Services Regulations (Northern Ireland) 2007 is amended so that 'relevant universal credit recipients' are entitled to a Health Service sight test under general ophthalmic services. The same £435 and £935 earned‑income thresholds and UC definitions apply, anchored to the claimant’s most recent assessment period.
For travel costs and charge remission, regulation 5 of the 2004 Travelling Expenses and Remission of Charges Regulations is amended to add 'relevant universal credit recipient' to the list entitled to full payment of HS travel expenses and full remission of specified HS charges. The Explanatory Note indicates that, from 1 December 2025, the entitlement is applied on the same earnings thresholds as the optical and ophthalmic provisions, without requiring a separate claim when the criteria are met.
Transitional provisions ensure no one loses out for activity before commencement. Payments for optical appliances remain available where eligibility existed immediately before 1 December 2025. Vouchers issued before that date but not yet accepted must be processed under the pre‑amendment rules. Where a sight test occurred before commencement without a voucher, regulation 6 of the Optical Charges Regulations continues to allow reimbursement as if the person were an eligible patient. For HS travel expenses and charge remission incurred or paid before 1 December 2025, the previous rules continue to apply.
What this means operationally is straightforward. Opticians and ophthalmic medical practitioners should verify the customer’s Universal Credit assessment period and earned income figure when determining entitlement from 1 December 2025. Front‑line staff should confirm whether the UC award includes the child, LCW or LCWRA elements, because that dictates the applicable threshold. Providers should update point‑of‑service systems to record the evidential basis used and to code 'relevant universal credit recipient' correctly.
For claimants, eligibility may change month to month because it tracks the Universal Credit assessment period. A single claimant with no child or LCW/LCWRA elements qualifies in any period where earned income is £435 or less; if earnings in a later period exceed £435, entitlement falls away. A claimant with the child element, or LCW/LCWRA, qualifies up to £935. Where a claimant is responsible for a qualifying young person, that young person can access optical vouchers and sight tests on the same terms.
Governance is explicit. The Regulations were made by the Department of Health with Department of Finance approval for remission of charges and jointly in relation to HS travel expenses. S.R. 2025 No. 172 amends S.R. 1997 No. 191, S.R. 2004 No. 91 and S.R. 2007 No. 436, and should be read alongside the Universal Credit Regulations (Northern Ireland) 2016. Providers and HSC finance teams should align internal guidance, budgeting and audit trails ahead of the 1 December 2025 commencement date.