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Help with health costs

This information applies to Scotland only

About this information

Most NHS treatment is free, including all prescription costs, 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 to financial help.

Health costs for which you can get help

You may be able to get help with:

  • 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.

You will need show evidence to prove you are eligible for help. You may be able to get some prescriptions and treatment without proof, but you will usually have to provide it later. If you can’t do this, you may have to pay the original costs plus a penalty charge

Help with dental treatment

Everyone is entitled to free NHS dental check-ups. You are entitled to other free NHS dental treatment if, at the start of the treatment, you:

  • are receiving or are entitled to receive Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance, the guarantee credit part of Pension Credit or Universal Credit. Your partner and children will also be entitled to free treatment if they are included in your benefit award
  • are under 18
  • are 18 and in full-time education
  • are pregnant, or have had a baby during the last twelve months. This includes if you have had a miscarriage after the 24th week of pregnancy, or your baby was stillborn.

If you are named on a valid HC2 certificate under the NHS low income scheme or getting Working Tax Credit and/or Child Tax Credit, you may be entitled to free dental treatment, depending on your income.

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

Everyone is entitled to free NHS sight tests. Between the ages of 16 and 59 you can have a free eye test every two years but if you have a known condition in the family, like glaucoma, you can have free tests every year.

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:

  • under 16
  • under 19 and in full-time education
  • needing complex lenses
  • entitled to a valid NHS tax credit exemption certificate
  • named on a valid HC2 certificate issued under the NHS Low Income Scheme
  • getting Income Support
  • getting income-based Jobseeker’s Allowance
  • getting income-related Employment and Support Allowance
  • getting the guarantee credit part of Pension Credit or Universal Credit.

Your partner and children will also be entitled to a voucher if they are included in your benefit award.

If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to help, depending on your income.

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

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.

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,the guarantee credit part of Pension Credit or Universal Credit. Your partner and children will also be entitled to help if they are included in your benefit award
  • get a war or service disablement pension and need to go to hospital for treatment for that disability.

If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to help, depending on your income.

If you need someone to travel with you for medical reasons, you might 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. You must make a claim for a refund within 3 months. If you can't afford to pay your travel costs in advance, you can ask for an advance payment. You may be eligible for a short term advance of benefit or a budgeting loan from the Department of Work and Pensions.

For information about short term advance of benefit and budgeting 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

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

NHS low income scheme error

Some people who applied to the NHS low income scheme between October 2003 and September 2008 may have paid too much towards their health costs, due to an error in the scheme’s calculations. This only affects a small number of people who meet certain criteria, but if you’re affected you can apply for a payment.

Find out whether you’re affected.

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

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.

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 printed from the NHS Business Services Authority website at www.nhsbsa.nhs.uk PDF . 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
Bridge House
152 Pilgrim Street
Newcastle-upon-Tyne
NE1 6SN
Tel: 0300 330 1343 or 0191 279 0565
Email: nhsbsa.lis1@nhs.net or enquiry form at www.ppa.org.uk
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. You must make the claim within 3 months of making the payment yourself.

To claim a refund, you will need form HC5. These are available from local benefit offices, NHS hospitals and some practitioners. The forms should be sent to 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 to 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. This is in addition to the original charge. For example, if you wrongly claimed for free dental treatment when the charge for the course of treatment is £30 you will have to pay a total of £130:

  • The original dental charge of £30 plus
  • The maximum penalty charge 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.

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