Help with health costs
Although most health treatment costs are covered by the NHS (in England, Wales or Scotland) or Health and Social Care (in Northern Ireland) some things may need to be paid for.
Depending on your circumstances, you may qualify for help towards some of these health costs.
What health costs do I have to pay for?
What you have to pay for varies depending on whether you live in England, Scotland, Wales or Northern Ireland.
- In Scotland, dental check-ups and eyesight tests are free.
- In Wales, dental check-ups are free for people aged under 25 or over 60.
- Prescriptions are free in Scotland, Wales and Northern Ireland, but they have to be paid for in England, where each item on the prescription currently costs £8.60.
- In England, people under 16, or under 19 and in full-time education, don’t have to pay for prescriptions, sight tests or dental treatment. People aged 60 or over qualify for free NHS eyesight tests and don’t have to pay for prescriptions.
People with certain medical conditions might not have to pay some charges.
For example, people with insulin-dependent diabetes get free prescriptions and people with glaucoma, or considered to be at risk of glaucoma, get free eye tests, wherever they live in the UK.
Can I get help with these health costs?
This includes free prescriptions, eye tests and vouchers for glasses, free dental treatment and travel costs to hospital.
If you do not get these benefits but have a low income, you may still be able to get some help with health costs through the Low Income Scheme (see below).
If you’re not sure whether you can get any of your costs paid for, call the NHS Help with Health Costs helpline on 0300 330 1343.
Help if you're on means-tested benefits
You will get free prescriptions, dental treatment, eyesight tests, wigs and fabric supports if you (or your partner,) get:
- income-related Employment and Support Allowance
- Income Support
- income-based Jobseeker’s Allowance, or
- Universal Credit (if you do not have earnings or combined earnings of more than £435 a month, or £935 a month if your award includes a child amount or you, or your partner, have a limited capability for work)
You will also get vouchers towards the cost of glasses or contact lenses.
If the cost of your glasses or contact lenses is more than your voucher value, you will need to pay the difference.
Contributory ESA and contribution-based Jobseeker’s Allowance
You aren't automatically entitled to help with your health costs if you get contributory Employment and Support Allowance (ESA) or contribution-based Jobseeker's Allowance. But you might get help under the Low Income Scheme (see below).
If you (or your partner,) get the Pension Credit ‘Guarantee Credit’, with or without Savings Credit, you can get the same help with health costs as people who get the means-tested benefits listed above.
If you only get the Pension Credit ‘Savings Credit’, you can’t automatically get help, but you might get help under the Low Income Scheme (see below).
Some people who get Working Tax Credit and/or Child Tax Credit may be able to get free prescriptions, depending on their income.
If you qualify, you will be sent a tax credit exemption certificate by the NHS Business Services Authority once your award has been confirmed by HM Revenue and Customs.
Your exemption certificate is valid until the expiry date stated on the card, regardless of any changes to your tax credit entitlement.
Help if you can’t go out
If you have an ongoing physical disability that prevents you from leaving home without help from someone else, you’ll get free prescriptions.
You can apply with an exemption form FP92A, which you can get from your doctor, pharmacist or hospital.
The NHS Low Income Scheme
The NHS Low Income Scheme gives income-related help with health costs for people who aren’t automatically exempt from health service charges, but who are on a low income.
The scheme is administered by the NHS Business Services Authority.
Under this scheme, you can qualify for full or partial help with all NHS charges and for vouchers for glasses and contact lenses.
The help you are entitled to depends on your income and circumstances. Any capital you have (your assets such as savings and property, minus your debt) must be below £16,000, or £23,250 (£24,000 in Wales) if you live permanently in a care home.
The NHS Business Services Authority will send you an HC2 certificate (for full help) or an HC3 certificate (for partial help) that determines the amount you have to contribute towards the charges.
Your partner and any children you are responsible for will also qualify for help with health costs once you qualify on low income grounds.
How can I apply for help?
To apply for help under the Low Income Scheme, you need to fill in an HC1 application form.
You can also ring the NHS Business Services Authority on 0300 123 0849 to get a form with a pre-paid return envelope.
Hospitals, GPs, dentists, opticians and advice agencies may also have forms available.
If you think you might be able to get help under the Low Income Scheme, you should apply now, as you can’t always predict what you might have to pay for in the future.
Help with prescription costs
If you need prescription items on a regular basis and you do not qualify for free prescriptions, you can sometimes save money with a Prescription Prepayment Certificate (PPC).
In England, each item you are prescribed will cost £8.60.
- A 3 month PPC costs £29.10 and covers all items you get during that period, so if you need 4 or more prescriptions in that time, you’ll save money with a PPC.
- A 12 month PPC costs £104, so if you need 13 or more prescriptions in a year, it will save you money.
To get a Prescription Prepayment Certificate, you can:
- Apply online on the NHS Business Services Authority website
- use form FP95, available from your local pharmacy
- call the NHS Business Services Authority on 0300 330 1341
Help with travel costs
The Healthcare Travel Costs Scheme covers any journeys you might make to an NHS hospital or similar place for health service treatment.
If you need to have someone with you, their travel expenses might also be paid for.
If you’re not able to use public transport because of your disability, you can claim the cost of taxi fares or the cost of car fuel (you must get the hospital to agree to this beforehand).
If you’re entitled under this scheme, the hospital can also refund the costs of journeys already made using claim form HC5.
There should be an office at the hospital where you can do this.
Do I qualify for help with travel costs?
You can get full help under this scheme if:
- you receive any of the following means-tested benefits: income-related Employment and Support Allowance, Income Support, income-based Jobseeker’s Allowance or the Guarantee Credit of Pension Credit, or
- you have an HC2 certificate under the Low Income Scheme.
You are entitled to partial help if you have an HC3 certificate under the Low Income Scheme (see above).