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Help with health costs

Find out more about how to get help with health costs.

1. What is Help with health costs?

If you are on a low income, on certain benefits, or fit other criteria, you, your partner and children might get help with National Health Service (NHS) costs including prescriptions, sight tests, dental treatment and travel to receive NHS treatment.

Applies to: England, Wales and Scotland

Age Rules: There are no age rules

Administered by: National Health Service

 
 

2. Can I get Help with health costs?

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


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 still qualify if you had a miscarriage after the 24th week of pregnancy, or your baby was stillborn)


NHS Low Income Scheme

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, you may if you have a low income be able to get help under the NHS low income scheme.   

For more information see the Low Income Scheme page of the NHS Business Services Authority website 

Updated May 2017

3. What help does it provide?

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

  • free prescriptions in England (they are free in Scotland and Wales)

  • free dental treatment and check-ups

  • free sight tests

  • vouchers for glasses or contact lenses (optical vouchers)

  • travel costs to hospital for  NHS treatment. 

  • travel costs if travelling abroad for treatment

  • wigs and fabric supports, for example, abdominal and spinal supports, and support tights. 
     

NHS Low Income Scheme

If you do not  automatically qualify for help with NHS charges but need help under the NHS low income scheme, you can apply for a certificate.

The amount of help you get will depend on the amount of income you have. You might not be entitled to any help at all if you have too much capital.

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.


 
 

4. How do I make a claim for Help with health costs?

  • 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.
     

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. Proof of entitlement to help with health costs

If you claim help with a health cost and you are unable prove that you are entitled, your claim will be checked and you may have to pay a penalty charge if it is found that you were not entitled to help.
 
The penalty charge will be five times the charge that you should have paid, up to a maximum of £100. If you fail to pay the penalty charge, the NHS can take action to recover the debt in court. The penalty charge will be increased by fifty per cent if you do not pay within 28 days of the date that the penalty notice is sent.

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.

NHS Low income scheme

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.

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.

If you need help making your claim, call their Customer Contact Team on: 0300 330 1343

You can also get a HC1 form in the following ways;

  • England, you can order an HC1 to be posted to you.
  • Scotland, you can download and print off an HC1.  A form can also be obtained at pharmacies, GP practices, Citizens Advice Scotland offices and Job Centre Plus offices.
  • Wales, you can get a HC1 Form by calling 0845 6031108 (select the option for health publications).  Jobcentre Plus offices, NHS hospitals, dentists and opticians may also stock them too


Prepayment certificates for prescriptions

In Wales and Scotland prescriptions are free. In England, there are a number of ways to buy a prepayment certificate which may make your prescriptions cheaper.

Further help

There is an NHS leaflet about health costs. You need to read the one for the country of the UK you live in. You can pick up a copy at your doctor's surgery, at the hospital, from the dentist or the optician. See also the Help with Health Costs page on the NHS Business Authority website

Northern Ireland: Help with health costs

Prescriptions are free in Northern Ireland. This includes medication, wigs and surgical appliances.

Some people may be entitled to help with other health costs because of age, their medical condition, benefits they are getting or because of a low income.

For more information, see the NI Direct website information on help with health costs in Northern Ireland

 

Updated June 2018

5. How do I challenge a Help with health costs decision?

You can ask for a formal review of the decision on your claim by writing to the;
 
Review Section at the NHS Business Services Authority
 
Telephone:          0300 330 1343 (low income scheme)
                            0300 330 1341 (medical and maternity exemption certificates)
 
If there are delays in obtaining  a certificate , you can complain to the customer services manager.

6. Northern Ireland: Help with health costs

Prescriptions are free in Northern Ireland. This includes medication, wigs and surgical appliances see the NI Direct website www.nidirect.gov.uk/help-with-health-costs (link opens in a new window)

Some people may be entitled to help with other help costs because of age, their medical condition, benefits they are getting or because of a low income.

For more information, see the NI Direct website information on help with health costs in Northern Ireland (link opens in a new window)