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Help with health costs

NHS Low Income Scheme (LIS)

If you have a low income, you may be able to get help with NHS costs through the NHS Low Income Scheme (LIS). The scheme covers:

You can apply for the scheme as long as your savings, investments or property (not counting the place where you live) don’t exceed the capital limit. In England, the limit is:

Any help you're entitled to is also available to your partner and any dependent young people.

How to apply

Depending on your circumstances, you can receive "full help" (HC2 certificate) or "partial help" (HC3 certificate). You will qualify for full help if your income is less than or equal to your requirements, or is greater than your requirements by no more than half the current English prescription charge. If your income exceeds this limit, you may be entitled to partial help. Your certificate will show how much you have to pay towards your health costs.

The rules governing who is eligible are broadly the same as those for Income Support. However, the assessment also takes into account council tax and housing costs, so you can get help with costs even if your income is too high for Income Support.

To apply for your certificate, you’ll need to complete an HC1 form and return it in the envelope provided.

You can order an HC1 form online or pick one up at your local Jobcentre Plus office and most NHS hospitals. Your doctor, dentist or optician may also be able to give you one.

If you need help making your claim or you have questions about the LIS, call 0300 330 1343 to speak to an adviser. They can also fill in the form for you and post it to you to sign. All you need to do then is post it back in the envelope provided.

For the answers to general questions about the Low Income Scheme, you can fill in an enquiry form online or read Low Income Scheme FAQs.

Certificates are usually valid for between six months and five years, depending on your circumstances.

You don't need to apply if you or your partner:

  • get Income Support
  • get income-based Jobseeker's Allowance
  • get income-related Employment and Support Allowance
  • get Pension Credit Guarantee Credit
  • are named on or entitled to an NHS Tax Credit Exemption Certificate

These benefits or tax credits already entitle you to full help with health costs.

Formal reviews

If you're unhappy with the outcome of your claim, you can ask for a review by a Service Improvement adviser. The Service Improvement team checks whether a claim has been correctly assessed in accordance with the regulations governing the scheme. If the decision was wrong, a new certificate will be sent to you.

You can request a review online or post your request to:

NHSBSA
Review Section,
Bridge House,
152 Pilgrim Street,
Newcastle-upon-Tyne,
NE1 6FS

How to claim back money that you have already paid

You can submit a claim for a refund at the same time as you apply to the Low Income Scheme. Refund claims must be submitted within three months of the date on which you paid.

To claim a refund of prescription charges, you'll need an NHS receipt form FP57. Ask for one when you pay for your prescription.

To claim a refund of other charges including dental treatment, wigs and fabric supports, sight tests, glasses or contact lenses and healthcare travel costs, you will need the relevant HC5 form.

Download your HC5 form:

Comments

The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Bexi1987 said on 22 July 2014

Why isn't there something like sports massages for injuries on the NHS? Physio was a waste of my time. I'm on ESA I can't afford this out of my measly benefits

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poppy247 said on 27 March 2014

I agree with barleydog's comment left on 17th Dec 2013 I too have to fill in a HC1 every year to get a HC2 and my circumstances havent changed since 2006, even at at the age of 62 which entitles me to free precreptions, eye tests certain dental treatment I still have to have a HC2 to prove that I am exempt.

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barleydog said on 17 December 2013

I do find it a bureaucratic waste of everyone's time that, in order to renew my HC2 Certificate (my circumstances have not changed), I must in effect re-apply by filling out an HC1 and posting it off. Why cannot this be done online?

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DianeYates said on 18 September 2013

I went to sign on today, I don't receive any money due to not claiming income support when I was made redundant in 2011, I mentioned to her that I struggle to read small writing and she said I would be entitled to help, she advised I go online and fill out HC11, she didn't give me a form and you cannot fill it out on line, come on NHS it's not difficult to get sorted, saves a huge amount of admin time and costs, helps towards your paperless service 2014 objective and makes it more customer centred. I am now going to give you my details to send me a form that will want my details again, I wander how long it will be before I get that eye test?

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pulforl said on 30 May 2013

I also find it confusing that there are two sets of criteria to claim NHS costs. On the one hand I am eligible for the disability element of tax credit which states I automatically get a tax exemption certificate. On phoning (as I cannot trace having had one or if I did I have lost it) I was told that I was above the earning allowance. Apparently though, I can apply for exemption under low income where I am actually eligible. I can only comment 'Left Hand-Right Hand' and are we therefore paying extra agents from the state to do the same job twice?

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pdfbt40 said on 11 May 2013

Is it really so difficult to give better guidance on eligibility and level of payments. Is filling in a 16 page paper form the only way.
My local council has an online calculator for Housing and Council Tax Benefit which can then convert to an application.
Why is it so difficult for NHS Choices England to do similar?

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harrym007 said on 10 March 2013

I find it really strange that two sets of criteria are used when qualifying for benefits because of low income. I am a 72 year old pensioner with a 67 year old spouse. For council tax benefit the government states that we need £241.65 a week to live on. For help with health costs the government states that we only need £217.90 to live on The discrepancy arises because there is two different sets of criteria. On one hand I can get limited council tax benefit of £5.04 p.w. On health costs for dental treatment I have to pay a whopping £124.44 max surely this cannot be right

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Page last reviewed: 15/03/2013

Next review due: 15/03/2015

Important numbers

Phone 0300 330 1348 for the dental services help line

Phone 0300 330 1343 for the Low Income Scheme help line

Phone 0300 330 1341 for queries about medical exemption certificates.

Phone 0300 330 1341 for queries about PPCs.

Phone 0300 330 1349 for the prescription services help line

Phone 0300 330 1347 for queries about tax credit certificates

Phone 0300 123 0849 to order a paper copy of the HC12 or HC5 forms

For all other queries call 0300 330 1343

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