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Site updated:

4 July 2009

Health - In England

Help with health costs

This information applies to England, Wales and Scotland

About this information

Most NHS treatment is free, but there are a number of things for which there may be charges. This information tells you what you might be able to get help with, and whether you might be entitled.

Health costs for which you can get help

You may be able to get help with:-

prescription charges
NHS dental charges, including check-ups
sight tests
vouchers towards the cost of glasses and contact lenses
travel costs to and from hospital for NHS treatment
travel costs if travelling abroad for treatment
wigs and fabric supports, for example, abdominal and spinal supports, and support tights.

Help with prescription charges

If you live in Wales, all prescriptions are free whatever your age and whether or not you get benefits.

In England and Scotland, you are entitled to get prescriptions free of charge if you:

are on Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Your partner and children will also be entitled to free prescriptions. If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to free prescriptions, depending on your income
are 60 or over (you must show proof of age to the pharmacist)
have a listed medical condition and have a valid medical exemption certificate. Ask your GP if you think this might apply to you
are having treatment for cancer, the effects of cancer or the effects of cancer treatment and you have a valid medical exemption certificate. You get free prescriptions for all NHS medication, not just the cancer medication (in England only)
you are on prescribed medication to prevent a pandemic disease, for example, pandemic influenza
have a continuing physical disability which means you cannot go out without help from another person and have a valid medical exemption certificate
are under 16 in England or Scotland. You must show proof to the pharmacist
get a war or service disablement pension, need prescriptions for your disability and hold an exemption certificate
are a prisoner
are pregnant, or have had a baby in the last twelve months and have a valid exemption certificate. This includes if you have had a miscarriage after the 24th week of pregnancy, or your baby was stillborn
have got a community care order and you are expected to take medication for the treatment of your mental disorder. This applies only to England.

In England, for a full list of people who can get help with prescription charges, see the Department of Health leaflet HC11 Help with health costs at: www.nhsba.nhs.uk.

To apply for a medical exemption certificate ask your GP, hospital or pharmicist for Form FP92A (EC92A in Scotland).

To apply for a maternity exemption certificate, ask your GP, midwife or health visitor for form FW8.

If none of the categories mentioned in this list applies to you, you may still be able to get free prescriptions on the grounds of low income – see under heading Help with health costs if you are on a low income.

In Scotland, for more information about help with prescription charges, see A quick guide to help with health costs (HCS2).

Prepayment certificates

If you need frequent prescriptions but do not qualify to get them free of charge, you can buy a prepayment certificate which will save you money.

In Scotland, you can get a certificate which lasts for either four or twelve months. You will usually benefit from buying a prepayment certificate if you have to pay for more than five prescription items in a four-month period, or more than 14 items in a twelve month period.

In England, you can get a prepayment certificate which lasts for either three or twelve months. You can pay for the twelve month certificate by direct debit, in ten equal monthly instalments.

Before buying a prepayment certificate, check that you are not entitled to free prescriptions, as it can be difficult to get a refund once you have paid for your certificate.

In England there are a number of ways to buy a prepayment certificate:

over the phone from the NHS Business Services Authority
from the NHS Business Services Authority website
from the pharmacist
from your Primary Care Trust

Contact details for the NHS Business Services Authority are:

NHS Business Services Authority
PPC Issue Office
PO Box 854
Newcastle Upon Tyne
NE99 2DE
Tel: 0845 850 0030
E-mail: ppc1@ppa.nhs.uk
Website: www.nhsba.nhs.uk.

In Wales, prescriptions are free so you don't need a prepayment certificate.

In Scotland you can buy a prepayment certificate at a pharmacy or from your doctor's surgery.

For more information about the costs of prepayment certificates, in England see NHS charges and optical voucher values and in Scotland see A quick guide to help with health costs (HCS2).

Help with dental treatment

You are entitled to free NHS dental treatment, including check-ups, if, at the start of the treatment, you:-

are getting Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Your partner and children will also be entitled to free treatment. If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to free dental treatment, depending on your income
are under 18
are 18 and in full-time education
live in Scotland (check-ups only)
in Wales, are under 25 (check-ups only)
in Wales, are 60 or over (check-ups only)
are pregnant, or have had a baby during the last twelve months, and hold a valid maternity exemption certificate. This includes if you have had a miscarriage after the 24th week of pregnancy, or your baby was stillborn. To apply for a maternity exemption certificate, ask your GP, midwife or health visitor for form FW8
are a prisoner.

In England, for a full list of people who can get help with dental treatment, see the Department of Health leaflet HC11 Help with health costs at: www.nhsba.nhs.uk.

In Scotland, for more information about help with dental charges, see A quick guide to help with health costs (HCS2).

You may have to show your dentist proof that you are entitled to free treatment. If your circumstances change before treatment ends, you will still be able to get free treatment.

If you are not in one of the categories listed above, you might still be able to get free dental treatment on the grounds of low income – see under heading, Help with health costs if you are on a low income.

Help with sight tests

You will be entitled to free NHS sight tests if you:-

are getting Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Your partner and children will also be entitled to free tests. If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to free NHS sight tests, depending on your income
are under 16
live in Scotland
are under 19 and in full-time education
are 60 or over
need complex lenses
are registered blind or partially sighted
have diabetes or glaucoma
are aged 40 or over and are the parent, brother, sister or child of someone with glaucoma, or you have been advised that you are at risk of glaucoma
are a war pensioner, and need a sight test because of a disability for which you get a war pension
are a hospital patient, and need a sight test for the management of your eye condition.

If you are not in one of the categories listed above, you may be able to get help towards the costs of a private sight test, on the grounds of low income – see under heading, Help with health costs if you are on a low income.

In England, for a full list of people who can get help with NHS sight tests, see the Department of Health leaflet HC11 Help with health costs at: www.nhsba.nhs.uk.

In Scotland, for more information about help with sight tests, see A quick guide to help with health costs (HCS2).

Help with the cost of glasses and contact lenses

You will be entitled to help towards the cost of prescription glasses or contact lenses if you:-

are getting Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Your partner and children will also be entitled to a voucher. If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to help, depending on your income
are under 16
are under 19 and in full-time education
need complex lenses
in England, are a prisoner on leave from prison
in England and Wales, are aged 16 or 17 and are financially maintained by your local authority.

If you are entitled to help towards the cost of prescription glasses or contact lenses, you will get an NHS optical voucher.

In Wales, if you are under 16, or under 19 and in full-time education and suffering from a specific illness, you may be able to get a voucher towards the cost of an additional pair of glasses or contact lenses.

For more information about the value of optical vouchers, in England see NHS charges and optical voucher values, in Wales see NHS charges and optical voucher values, and in Scotland see A quick guide to help with health costs (HCS2).

If you are not in one of the categories listed above, you may still be able to get help towards the costs of prescription glasses or contact lenses on the grounds of low income – see under heading, Help with health costs if you are on a low income.

In England, a full list of people who can get help with the cost of glasses and contact lenses, see the Department of Health leaflet HC11 Help with health costs at: www.nhsba.nhs.uk.

In Scotland, for more information about help with the cost of glasses and contact lenses, see A quick guide to help with health costs (HCS2).

Help with travel costs for NHS treatment

You can get essential travel costs paid to and from a place where you receive certain types of NHS treatment, if you are:

getting Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Your partner and children will also be entitled to help. If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to help, depending on your income
get a war or service disablement pension and need to go to hospital for treatment for that disability.

In England, for a full list of people who can get help with travel costs for NHS treatment, see the Department of Health leaflet HC11 Help with health costs at: www.nhsba.nhs.uk.

In Scotland, for more information about help with travel costs for NHS treatment, see A quick guide to help with health costs (HCS2).

If you need someone to travel with you for medical reasons, you can get their travel costs paid as well.

You can claim a refund of your travel costs by filling in form HC5 and giving it to the place you go to for NHS treatment. If you can't afford to pay your travel costs in advance, you can ask for an advance payment. Alternatively, you may be able to get a crisis loan from the social fund.

For more information about crisis loans, see Help for people on a low income - the Social Fund.

If you are not in one of the categories listed above, you might still be able to get help with your travel costs on the grounds of low income – see under heading, Help with health costs if you are on a low income.

Help with the cost of wigs and fabric supports

England and Scotland

If you have been prescribed an NHS wig or fabric support by a hospital, you will be able to get it free if you are getting Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Your partner and children will also be entitled to free wigs and fabric supports. If you are getting tax credits, you may be entitled to help, depending on your income.

If you aren't getting one of these benefits or tax credits, you may be entitled to free wigs or fabric supports if you:

are under 16
are under 19 and in full-time education
are a hospital in-patient when the wig or fabric support is supplied
get a war or service disablement pension and need a wig or fabric support because of your disability
are a prisoner.

If you are not in one of the categories listed above, you might still be able to get help with the cost of wigs and fabric supports on the grounds of low income – see under heading, Help with health costs if you are on a low income.

In England, for a full list of people who can get help with the cost of wigs and fabric supports, see the Department of Health leaflet HC11 Help with health costs at: www.nhsba.nhs.uk.

In Scotland, for more information about help with the cost of wigs and fabric supports, see A quick guide to help with health costs (HCS2).

Wales

In Wales, you can get a free NHS wig or fabric support, if you have been prescribed one, whatever your age, income or personal circumstances.

Help with health costs if you are on a low income

If you have difficulty in meeting your health costs and do not qualify for any other kind of help, you may be able to get help under the NHS low income scheme.

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), and a limited help certificate (HC3), which tells you how much you have to pay.

Full help certificate

If you are entitled to a full help certificate, you will get:-

free NHS prescriptions
free NHS dental treatment, including check-ups
free NHS sight tests (including sight tests at home) and full value vouchers for glasses or contact lenses
full repayment of necessary travel costs for hospital treatment
full repayment of travel costs if travelling abroad for treatment
free NHS wigs and fabric supports
travel costs if travelling abroad for treatment.

Limited health certificate

If you are entitled to a limited help certificate, you may be able to get some help with the costs of:-

dental treatment and check ups
private sight tests
vouchers for glasses or contact lenses
wigs and fabric supports
necessary travel costs to and from hospital for NHS treatment
travel costs if travelling abroad for treatment.

You will not be entitled to any help with the costs of prescriptions.

How to apply for help on the low income scheme

To apply for either a full help certificate (HC2) or a limited help certificate (HC3), complete form HC1, which is available from local benefit offices, NHS hospitals, dentists, opticians and pharmacists. Form HC1 can also be filled in online. You do not have to wait until you need treatment before you apply for a certificate. Send the completed form HC1 to:

NHS Business Services Authority
PO Box 370
Newcastle Upon Tyne
NE99 2ZA

Tel: 0845 850 1166
Website: www.nhsbsa.nhs.uk.

How to claim a refund under the low income scheme

If you do not have a certificate under the low income scheme when you pay a health charge, but think that you might be entitled to one, you can make a claim for a refund.

To claim a refund of prescription charges, you must ask the pharmacist for form FP57 (or HCS(R) in Scotland) at the time that you pay the charge. You will not be able to get this form at a later date. For all other health charges, you will need form HC5 to claim your refund. These are available from local benefit offices, NHS hospitals and some practitioners. The forms should be sent to the the NHS Business Services Authority – see above.

If you are entitled to help under the low income scheme, any refund due will be paid when you get your certificate.

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.