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HCS 2: A Quick Guide to Help with Health Costs: Includes Charges and Optical Voucher Values

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CAN YOU GET FREE PRESCRIPTIONS?

The list opposite will help you check whether you are entitled to free prescriptions.

If you are, take proof of entitlement with you when you take your prescription to the pharmacy.

If you forget to take proof with you, you will receive the prescription without charge, but checks are made on people who do not provide evidence.

If you are found to have claimed exemption wrongly, you will be asked to repay the charge and will also be served with a notice requiring payment of an additional penalty charge.

Please note:
Patients exempt from NHS prescription charges on age grounds need not produce evidence where their date of birth is specified in an electronic prescription form or printed by a computer on a non-electronic prescription form.

However, patients exempt on age grounds will still be required to sign the patient declaration on the reverse of the prescription form as confirmation that the medicine or appliance ordered was dispensed.

YOU DO NOT HAVE TO PAY FOR NHS PRESCRIPTIONS IF YOU:
  • are under 16 years old;
  • are 16, 17 or 18 and in qualifying full-time education;
  • are 60 years of age and over;
  • have a specific listed medical condition which confers exemption;
  • have a valid Maternity Exemption Certificate (EC92);
  • have a valid War Pension Exemption Certificate;
  • have a valid Prescription Pre-payment Certificate;
  • get, or has a partner who gets, Pension Credit Guarantee Credit;
  • get, or has a partner who gets, Income Support;
  • get, or has a partner who gets, Income-related Employment and Support Allowance;
  • get, or has a partner who gets, Income-Based Jobseeker's Allowance;
  • hold, or are named on, a valid NHS Tax Credit Exemption Certificate;
  • are named on a current NHS Low Income Scheme certificate HC2 'Help with health costs'.

YOUNG PEOPLE

Are you aged 16, 17 or 18 and in qualifying full-time education?

If the answer is YES, then you are entitled to the following NHS items and services free of charge:
NHS Prescriptions
NHS Dental Treatment (young people under 18 do not have to be in education to qualify)
NHS Wigs and Fabric Supports
Voucher towards the costs of glasses or contact lenses.

PEOPLE AGED 60 AND OVER

If you are aged 60 or over then you are entitled to receive:
Free NHS Prescriptions
Free NHS Wigs and Fabric Supports.

PEOPLE RECEIVING BENEFITS

Are you (or your partner if you have one) receiving:

  • Income Support?
  • Income-related Employment and Support Allowance?
  • Income-based Jobseeker's Allowance?
  • Pension Credit Guarantee Credit? or
  • Do you have an NHS Tax Credit Exemption Certificate?

If the answer is YES to any of the above then you are entitled to all of the items and services free of charge, plus:
Vouchers towards the cost of glasses or contact lenses
A refund of any reasonable amount spent on travel to receive treatment at an NHS hospital.
To claim your entitlement, tell the practitioner when you have your treatment that you think you don't have to pay. The practitioner will ask you for evidence that you don't have to pay and ask you to sign a form.
Note: If you are receiving a benefit not listed previously, check the rest of this leaflet to see whether you might be entitled to help on other grounds.

PEOPLE ON A LOW INCOME

If none of the circumstances already mentioned applies to you, but you have difficulty paying NHS charges, you may qualify for help under the NHS Low Income Scheme. This is an income-related scheme which looks at your (and your partner's) weekly requirements and income to calculate how much, if anything, you should pay towards your health costs.

The threshold for full help under the Scheme changes from time to time, so if you haven't claimed for a while, it may be worth making a new claim.

If you want to claim help under the Low Income Scheme, pick up form HC1 at Community Pharmacies, GP Practices, Citizens Advice Scotland Offices and Jobcentre Plus offices.

You can also get a form, advice on completing it,or information and general advice by calling a helpline on: 0845 850 1166 (calls are charged at local rate).

WOMEN WHO ARE PREGNANT OR WHO HAVE GIVEN BIRTH IN THE LAST 12 MONTHS

You are entitled to receive:
Free NHS Prescriptions
Free NHS Dental Treatment
To get these, you will need to apply for an NHS Maternity Exemption Certificate.
Application forms are available from your GP, midwife or health visitor. They will help you to complete the form and will send it to your NHS Board. You will receive your certificate by post.

PEOPLE WITH CERTAIN MEDICAL CONDITIONS

If you have one of the following medical conditions, apply for an NHS Medical Exemption Certificate that will entitle you to receive NHS prescriptions wigs and fabric supports free of charge. The exempting conditions are:
hypoparathyroidism
hypoadrenalism for which specific substitution therapy is essential ( e.g. Addison's Disease)
diabetes insipidus and other forms of hypopituitarism
diabetes mellitus except where treatment is by diet alone
myasthenia gravis
myxoedema (that is, hypothyroidism requiring thyroid hormone replacement)
epilepsy requiring continuous anti-convulsive therapy
A permanent fistula requiring continuous surgical dressing or requiring an appliance (also referred to as a stoma)
In addition to these conditions, if you have a continuing physical disability which means that you are unable to leave your home without the help of another person you might also qualify.
To apply for a Medical Exemption Certificate, ask the receptionist at your GP surgery. An application form EC92A will be completed at the surgery, and will be endorsed by your GP. The surgery will send off the application to your NHS Board and you will receive your certificate by post.

PEOPLE BEING TREATED FOR TUBERCULOSIS

You will be entitled to receive NHS prescriptions free of charge for the following drugs or preparations when prescribed for the treatment of tuberculosis.

Amikacin
Capreomycin
Cylocersine
Ethambutol
Isoniazid
Macrolides
Protionamide
Pyrazinamide
Pyridoxine
Quinonlones
Rifabutin
Rifampicin
Streptomycin

NHS PRESCRIPTION CHARGES from 1 April 2009

  • Charge per prescribed item £4.00

For items dispensed in combination (duo) packs, there is a prescription charge for each different drug in the pack.

REFUNDS

If you are paying prescription charges but think that you might want to claim a refund, ask the pharmacist for an NHS receipt (form HCS(R)) when you pay the charge.

You can only get a receipt at the time you pay the charge. The receipt tells you what you need to do to claim a refund.

Claims must be made within three months of the date you paid the charge.

If you have applied for help under the NHS Low Income Scheme but have not yet received a reply complete form HC5 and send it with the receipt to:

Patient Services, Business Services Authority, Sandyford House, Archbold Terrace, Newcastle-upon-Tyne NE2 1DB.

You can get an HC5 from:

  • your local Jobcentre Plus office
  • your local hospital
  • some dentists and opticians
  • www.ppa.nhs.uk - (it will be posted to you)
  • by request from Patient Services on:
    0845 850 1166
    (calls are charged at the local rate)

CHARGES

PRESCRIPTION PREPAYMENT CERTIFICATES ( PPC) from 1 April 2009

  • 4 months £13.00
  • 12 months £38.00

NHS WIGS AND FABRIC SUPPORTS

  • Stock modacrylic wig £4.00*
  • Partial wig - human hair £4.00*
  • Full bespoke wig - human hair £4.00*
  • Abdominal support £4.00*
  • Spinal support £4.00*
  • Surgical brassiere £4.00*
  • Support stockings - each £4.00
  • Support tights - per pair £8.00*

*Available from hospitals only

HOSPITAL TRAVEL COSTS

If you are eligible to receive free prescriptions you may also be eligible for help with necessary travel costs.

The maximum you will pay if you live in the Scottish Highlands and Islands is:

  • Scottish Highlands and Islands £10.00

NHS DENTAL TREATMENT from 1 September 2009

  • Basic examination FREE*
  • Extensive clinical examination FREE*
  • Simple scale and polish £10.10
  • Two small X-rays and one small filling from £13.17
  • Two small X-rays and one large filling from £23.92
  • A precious metal crown from £101.41
  • Full set of plastic dentures from £139.04
  • An upper or lower metal denture from £122.53

You pay 80 per cent of the cost of the treatment up to a maximum of £384 if you can't get free treatment or help with the cost. The above are only examples of what you might pay for courses of treatment that start on or after 1 September 2009. The total cost of NHS treatment may be different from these examples because of the number, or types, of treatment involved. If you are registered for Continuing Care with your dentist, you may ask your dentist for a treatment plan. This is provided free of charge and explains what treatment your dentist recommends, the price for each part of the treatment, and the likely total cost.

* To people who are ordinarily resident in the UK or who belong in one of the categories for exemption from NHS charges set out in the NHS (Charges to Overseas Visitors) (Scotland) Regulations 1989.

SIGHT TESTS

  • NHS eye examination FREE*
  • NHS eye examination at home FREE*
  • Hospital eye department test FREE
  • Private sight test see your optician
  • Private sight test at home see your optician

NHS VOUCHERS FOR GLASSES AND CONTACT LENSES from 1 April 2009

Optical vouchers

Maximum value per pair of glasses or contact lenses

Single vision

A

£36.20

B

£55.10

C

£80.60

D

£182.00

Bifocal

E

£62.70

F

£79.70

G

£103.30

H

£200.10

Hospital eye department

I

£186.40

J (per lens)

£52.90

Complex lens - single vision

£13.70

Complex lens - bifocal

£34.60

* To people who are ordinarily resident in the UK or who belong in one of the categories for exemption from NHS charges set out in the NHS (Charges to Overseas Visitors) (Scotland) Regulations 1989.

Supplements to vouchers where clinically necessary

per lens

  • Prism

P

Single vision

£11.80

P

Bifocal

£14.20

  • Tint

T

Single vision

£4.00

T

Bifocal

£4.50

Photochromic

Single vision

£4.00

Other lenses

£4.50

Special frames

per frame up to

£59.70

Repairs/replacements of glasses or contact lenses

If, exceptionally, you are entitled to a voucher for repair or replacement, its value will be up to the figures show in this leaflet, depending on the part which needs replacing or repairing.

THE PENALTY CHARGE

A penalty charge may be imposed on patients who are found to have wrongly claimed total or partial help with health costs.

The penalty charge is five times the amount owed, up to a maximum of a £100. This is in addition to the original charge. For example:

Prescriptions penalty charge

A patient who wrongly claims to be eligible for free prescriptions when the charge is £4.00 will have to pay:

  • The original charge of £4.00
  • A penalty charge of £20.00
  • TOTAL £24.00

For advice call 0845 601 2912

Dental costs penalty charge

A patient who wrongly claims free dental treatment when the charge for the course of treatment is £30 will have to pay:

  • The original dental charge of £30
  • The maximum penalty charge of £100
  • TOTAL £130

COUNTER FRAUD SERVICES ( CFS)

NHSScotland Counter Fraud Services offers a free and confidential service for reporting potential fraud. You can contact CFS on 08000 151628.

PRESCRIPTION PRE-PAYMENT CERTIFICATES

Prescription Pre-payment Certificates ( PPCs) can save money for people who require large quantities of medicine or regular prescriptions, but are not entitled to free prescriptions.

A PPC will save you money if you require more than 3 prescription items in a 4month period or more than 9 prescription items in a 12month period.

As a PPC holder you do not have to pay for individual prescriptions while your certificate remains valid. PPCs can be used to claim exemption from charges for medicines, dressings, medical appliances, elastic hosiery and wigs prescribed on the NHS and dispensed by community pharmacists, dispensing doctors or appliances suppliers.

You can obtain a PPC:

  • Over the counter from an NHS community pharmacy or dispensing surgery.
  • By post from your regional office of NHS National Services Scotland at the following addresses:

For Ayrshire & Arran, Dumfries & Galloway, Greater Glasgow & Clyde, Lanarkshire and Western Isles write to:

Practitioner Services
Clifton House
Clifton Place
Glasgow G3 7LN


Tel: 0141 300 1300.

For Borders, Fife, Forth Valley and Lothian write to:

Practitioner Services
PO Box 17363
Edinburgh
EH12 1ET


Tel: 0131 275 7038.

For Grampian, Highland, Orkney, Shetland and Tayside write to:

Practitioner Services (Medical)
Bridge View
1 North Esplanade
West Aberdeen AB11 5QF


Tel: 01224 358400.

Duplicate PPCs

If you lose or damage your PPC while it is still valid, you can obtain a replacement from NHS National Services Scotland by writing to the office which serves the area where you live, giving your name, address and date of birth. While you are waiting for your replacement certificate, you will still be able to obtain your prescriptions free of charge.

PPC refunds

In certain circumstances a full or partial refund may be available. Ask at your pharmacy or dispensing doctor's surgery for a Refund Application Form, which gives more information.

Full refunds

You can claim a full refund if, during the first month of validity, the PPC holder became entitled to free prescriptions on grounds of:

  • Age
  • Medical Condition
  • Maternity
  • Low Income, or receipt of a benefit/tax credit which appears on the back of the prescription form; or
  • Was admitted to hospital and remained there until the PPC expired.
  • A full refund can also be claimed if during the first month of validity the PPC holder died or went into hospital and subsequently died there while the certificate was still valid.

Interpretation Services
If English is not your first language, we will provide a telephone interpreting service on all of the numbers shown in this leaflet. When you telephone tell us in English, or ask a friend to tell us, your preferred language and we will arrange for an interpreter.
This normally takes between 30 seconds and one minute.

Other special needs

This leaflet can also be made available by request on audio cassette, on disk and in large print.

All of the numbers on this leaflet offer typetalk for people who are hard of hearing. This is available Monday to Friday 8am to 6pm.

NHS Helpline on 0800 224488 will be able to provide both these services.

This is not a definitive guide to the help available. For more detailed information go to the following website to access the booklet HCS 1, 'Are you entitled to help with health costs?':www.scotland.gov.uk/healthcosts

Alternatively contact:

Scottish Government Health Directorates
Directorate of Primary Care and Community Care
Primary Care Division, St Andrew's House
Regent Road, Edinburgh EH1 3DG


Tel: 0131 244 2529.