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NHS in England: help with health costs

Help with health costs for people getting Universal Credit

If you receive Universal Credit, you may also qualify for help with health costs.

Eligibility criteria

You qualify if, on the date you claim help with health costs:

a) you receive Universal Credit and either had no earnings or had net earnings of £435 or less in your last Universal Credit assessment period

or

b) you receive Universal Credit, which includes an element for a child, or you (or your partner) had limited capability for work and work-related activity, and you either had no earnings or net earnings of £935 or less in your last Universal Credit assessment period

Note: If you're part of a couple, the net earning threshold applies to your combined net earnings.

You should present a copy of your Universal Credit award notice to prove your entitlement. You'll need to have met the eligibility criteria in the last completed Universal Credit assessment period before your health costs arose.

Visit the GOV.UK website for more information about the Universal Credit assessment period.

Not all help with health costs claim forms have a tick box for Universal Credit. If that's the case, you should tick the box for income-based Jobseeker's Allowance instead.

Find out more:

Unsure if you meet the eligibility criteria?

You should pay for any health costs if you're unsure whether you meet the eligibility criteria. You can claim a refund once you're able to confirm your entitlement.

This might be the case because:

  • your Universal Credit claim is still being assessed
  • you're waiting for a decision about your Universal Credit claim that might change the threshold that applies to you
  • you're uncertain whether your earnings are within the threshold

You need to have met the eligibility criteria either in the Universal Credit period before you paid, or in the same assessment period in which you paid, to qualify for a refund. 

Make sure you ask for and keep receipts. If you pay for a prescription, you must get a receipt and refund form (FP57) at the time you pay, as you won't be able to get one later.

Follow the NHS Business Services Authority (BSA) on Facebook or Twitter for the latest NHS BSA updates and answers to your questions about help with health costs.

How to claim a refund for health costs paid before December 1 2016

Before December 2016, the eligibility criteria only considered net earnings for the individual claimant, even for those who were part of a couple.

This means if you paid for health costs before December 2016, you may still be able to claim a refund under the old eligibility criteria, looking at only your net earnings at the time you paid.

Important numbers

Dental services helpline – 0300 330 1348

NHS Low Income Scheme helpline – 0300 330 1343

Prescription services helpline – 0300 330 1349

Queries about medical exemption certificates – 0300 330 1341

Queries about prescription prepayment certificates (PPCs) – 0300 330 1341

Queries about tax credit certificates – 0300 330 1347

Call 0300 123 0849 to order a paper copy of the HC12, HC5 and HC1 (SC) forms

Call 0300 330 1343 for all other queries

Page last reviewed: 31/01/2017

Next review due: 31/01/2020