Help with health costs

 

Index

You can read through this information sheet, or go directly to the sections you want to read by clicking on these links:

• Who does it help?
• Is it means-tested?
• What help does it provide?
• How much does it pay?
• How do I make a claim?
• What documents will I need?
• Further help

Who does it help?

You will qualify for full help with health costs if you get:

• Income Support
• income-related Employment and Support Allowance
• income-based Jobseeker’s Allowance
• the guarantee credit part of Pension Credit.

If you are getting Working Tax Credit and/or Child Tax Credit, you may get help.

Some people may qualify for help whatever their income. 

For example, you can get free prescriptions if you:

• are over 60
• are having treatment for cancer
• live in Wales
• live in Scotland

You can also get free prescriptions and dental treatment if you:

• are pregnant
• have had a baby in the last twelve months and have a valid exemption certificate (you will qualify even if you had a miscarriage after the 24th week of pregnancy, or your baby was stillborn)

If you have difficulty in meeting your health costs but you do not qualify for full help through entitlement to one of the benefits listed above, or free prescriptions, you may be able to get help under the NHS low income scheme.   

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Is it means-tested?

For the NHS low income scheme, the amount of help you get depends on the amount of income you have and you might not get any help at all if you have more than £16,000 in savings.

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What help does it provide?

If you qualify for full help, you, your partner and your children get:

• free prescriptions
• free dental treatment and check-ups
• free sight tests
• vouchers for glasses or contact lenses (optical vouchers)
• travel costs to hospital for treatment. 

If you do not qualify for free treatment but need help under the low income scheme, you can apply for a certificate. There are two types of certificate:

• a full help certificate (HC2)
• a limited help certificate (HC3) which does not qualify you for free prescriptions.

If you need frequent prescriptions but do not qualify to get any help with the cost, you can buy a prepayment certificate which will save you money.

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How much does it pay?

You do not actually get any money. The healthcare professional is paid directly for the care they give you.

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How do I make a claim?

• If you qualify for free prescriptions, claim help by filling in the back of your prescription form
• If you qualify for free dental care, sign the form they give you when you go for treatment
• If you qualify for free sight tests, when you go for a sight test, tell the optician if you are entitled to a free NHS sight test and ask for Form GOS1 to apply for it
• If you qualify for travel to hospital for treatment, when you go to hospital, tell them that you want to claim back the cost of your journey.

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Maternity exemption certificate

Apply on form FW8 which you can get from doctors, midwives and health visitors. You must fill in parts 1 and 2 of the form and then ask your doctor, midwife or health visitor to confirm that the information you have given is correct. They then send the form off to the NHS and you should receive the certificate within 21 days.

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Low income scheme

To apply for either a full help certificate or a limited help certificate through the low income scheme, fill in form HC1, which is available from local benefit offices, NHS hospitals, dentists, opticians and pharmacists. Or you can get Form HC1 online (link opens in a new window) . If you need help making your claim, call their Customer Contact Team on: 0845 850 1166. They can fill the form in for you if you wish, and send it to you just to sign and return.

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Prepayment certificates for prescriptions

In Wales and Scotland prescriptions are free. In England, there are a number of ways to buy a prepayment certificate:

• Over the phone from the NHS Business Services Authority on: 0845 850 0030
• From the NHS Business Services Authority website (link opens in a new window) 
• At a pharmacy.

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What documents will I need?

In most cases, you will need a national insurance number. You will usually need to show evidence of:

• Your identity, and
• Your income and savings or evidence that you are claiming certain benefits. 

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Further help

NHS Direct has a helpline that you can phone if you are concerned about a health problem or if you need details of local doctors, pharmacists, dentists and support groups. They can also give more information about health costs. In England and Wales, call them on: 0845 46 47.  In Scotland, call them on:  08454 24 24 24.

There is a NHS leaflet about healthcare costs (link opens in a new window PDF file size 288kb). You can also pick up a copy at your doctor's surgery, at the hospital, from the dentist or the optician.

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This information has been produced by Citizens Advice. 

Last updated: 6 April 2012