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 might need to be paid for.

Depending on your situation, you might qualify for help towards some of these health costs.

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What you have to pay for depends on whether you live in England, Scotland, Wales or Northern Ireland.

For example:

  • 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 £9
  • In England, people under 16, or aged 16-18 and in full-time education, don’t have to pay for prescriptions or sight tests. And people under 18 (or under 19 and in full-time education) don’t have to pay for 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 who are considered to be at risk of glaucoma, get free eye tests, wherever they live in the UK.

This also applies if you're pregnant or gave birth in the last 12 months, permanently live in a care home, in prison or a young offender’s institution.

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You can get help with health costs if you receive income-related Employment and Support Allowance (ESA), Income Support, income-based Jobseeker’s Allowance or the Guarantee Credit of Pension Credit, and some people who get Child Tax Credit and Working Tax Credit (depending on income and circumstances).

If you get Universal Credit, eligibility criteria may apply (see 'Help if you're on means-tested benefits' below).

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 helpline on 0191 232 5371.

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You'll get free prescriptions, dental treatment, eyesight tests, wigs and fabric supports if you (or your partner, if you have one) receive:

You'll 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'll 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).

Pension Credit

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).

Tax credits

You may be able to get free prescriptions if you get Working Tax Credit and/or Child Tax Credit, depending on your income. 

You'll get help with health costs if you earn less than £15,276 a year, and get one of these combinations of tax credits:

  • Tax Credit on its own
  • Working Tax Credit and Child Tax Credit paid together
  • Working Tax Credit on its own with a disability element or severe disability element.

If you qualify, you'll 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 certificate, regardless of any changes to your tax credit entitlement.

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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 FP92A form provides exemption for a long list of conditions including epilepsy, diabetes or people who are receiving cancer treatment.

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This scheme helps 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're entitled to depends on your income and circumstances.

Any capital you have (which is your assets such as your savings and property, minus your debt) must be below £16,000, or if you live permanently in a care home, it must be under £23,250 (or £24,000 in Wales). 

The NHS Business Services Authority will send you an HC2 certificate (for full help) or an HC3 certificate (for partial help). This will decide how much you have to contribute towards the charges. 

Your partner, if you have one, and any children you're responsible for will also qualify for help towards their health costs if you are eligible. 

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 330 1343 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.

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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 £9.

  • 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 12 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
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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 get 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
  • you get 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 have a limited capability for work)
  • 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).

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