Claiming Help When You Go For Treatment
Free NHS Dental Treatment:
Tell the dentist you want NHS treatment when you make the appointment. Sign the form you are given when you go for treatment. If you don’t have to pay put a cross in the appropriate box. If you have a valid HC2 NHS Low Income Scheme certificate, write in the certificate number.
If you have a valid HC3 NHS Low Income Scheme certificate for partial help, write in the certificate number and the maximum amount your certificate says you can pay. You will pay the amount that appears on the certificate, or the actual charge, whichever is less. See leaflet HCS2 for details of charges.
If your circumstances change before you are asked to pay, read page 8 (see pdf for page numbers) to see if you are entitled to free NHS dental treatment.
You will be asked to show proof of your entitlement to help with NHS dental charges – read page 30 (see pdf for page numbers) and the tables on pages 35 and 36 (see pdf for page numbers) for more information about this.
When you claim help with NHS dental charges, you are responsible for knowing whether or not you are entitled and for the declaration you make when signing the form for treatment.
You cannot get help with charges for private dental treatment or for other items such as toothbrushes.
You should ask your dentist how much your treatment plan will cost. You will only pay one charge for a course of treatment, even if you need to go to the dentist more than once to complete the course. However, your dentist may collect the charge in instalments.
NHS Vouchers For Glasses Or Contact Lenses
If you are entitled to a voucher towards the cost of glasses or contact lenses you will be issued with a GOS(S)3 voucher form following your NHS eye examination. If you become entitled to a voucher after your eye examination ask the person who is supplying your glasses or contact lenses for one. Not all suppliers have GOS(S)3 voucher forms and you might have to go back to the person who undertook your eye examination to get one.
A GOS(S)3 voucher form is valid for 2 years, but you can only use it if you are still entitled to a voucher for glasses or contact lenses when you order them.
You will be asked to fill in and sign the GOS(S)3 when you order glasses or contact lenses to say why you are entitled to the voucher and to confirm that you have received your glasses or contact lenses. If you have a valid NHS Low Income Scheme HC2 certificate for full help with health costs, or HC3 certificate for partial help, write in the certificate number. If you have a valid HC3 certificate you must also write in the amount your certificate says you have to pay towards your voucher. Your voucher value will be reduced by this amount.
Repair Or Replacement Of Glasses Or Contact Lenses
Ask your optician for form GOS(S)4 – it tells you what to do.
Claiming Help With Travel Costs To And From Hospital
When you go for treatment, tell the hospital that you want to claim back the cost of your journey and show proof of your entitlement such as your Pension Credit entitlement notice, your NHS tax credit exemption certificate or your NHS Low Income Scheme HC2 certificate. Also, keep any tickets or receipts you have as proof of the cost.
If you have a valid NHS Low Income Scheme HC3 certificate and your journeys cost more in total in any one week than your certificate says you have to pay, show the HC3 certificate at the hospital and ask if you are entitled to any money back.
Information About Checks Of Entitlement
If you are claiming free NHS treatment, or using an optical voucher, you should show proof of why you don’t have to pay or why you can use a voucher, e.g. a benefit book or birth certificate. For more information about this read the tables on pages 35 (see pdf for page numbers) onwards.
If you cannot show proof, you will get your NHS treatment free, or be able to use your optical voucher. However, your treatment form will be marked ‘no evidence seen’ and your entitlement may be checked later.
NHSScotland Counter Fraud Services will check claims for:
- Full or partial help with NHS dental treatment.
- Vouchers towards the cost of glasses or contact lenses.
How To Claim A Refund
You have to claim a refund within 3 months of paying the health cost.
You will need a receipt which shows you have paid for NHS treatment (see following paragraphs for details). If you are claiming because of low income use form HC5 available from Jobcentre Plus offices or NHS hospitals. Your dentist or optician may have one. The HC5 tells you what to do.
If you want to apply for a refund for other reasons, you will need to write a letter, enclosing your receipt, to your local office of the NHS National Services Scotland Practitioners Services (see addresses on page 34) (see pdf for page numbers).
NHS Dental Treatment Refunds
Refunds are only available for NHS dental treatment. Ask your dentist for a NHS receipt form GP17D or a receipt which shows the amount and the date you paid the charge.
If you are claiming on the grounds of low income complete form HC5. The form tells you what to do.
If you are paying the NHS dental charge by instalments, you will need a receipt for each instalment. Save all the receipts and send them off with the HC5 when you have finished paying. The claim must be received within 3 months of paying the final instalment.
If you want to claim a refund for another reason, e.g. because you receive confirmation that you are pregnant, you will need to explain in writing why you are claiming a refund. Write to: NHS National Services Scotland, Practitioner Services, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. Enclose your receipt and make sure you include your full name and the address of your dentist.
You cannot have a refund of charges for private dental treatment or for other items such as toothbrushes.
Checks will be made before sending out any payment.
Glasses Or Contact Lens Refunds
If you have already used a voucher towards the cost of your glasses or lenses you cannot get a refund, unless it was only a ‘complex lens’ voucher. Nor can you claim a refund of the difference between the voucher value and the actual cost of your glasses or lenses, even if they cost more than the voucher value.
If you want to claim a refund, ask the person who supplies your glasses or contact lenses for a receipt which shows how much you paid and the date of payment. Complete an HC5 refund form and make sure you enclose your optical prescription and your receipt with your HC5 when you send it off. The form tells you what to do. The maximum refund you can get back will be the voucher value which matches your prescription.
Lost Or Damaged Glasses Or Contact Lenses
If your glasses or contact lenses have been lost or damaged and you pay for replacement or repairs, you will only be considered for a refund if you are entitled to a voucher. But, Practitioner Services of NHS National Services Scotland has to agree that the loss or damage was due to illness or disability before payment can be made – read page 23 (see pdf for page numbers).
Hospital Travel Costs Refunds
Usually, an NHS hospital will give you your refund when you go for treatment. If this is not possible, ask the hospital for an HC5 refund claim form – the form tells you what to do.
The Penalty Charge
Any patient found to have falsely claimed help with health costs will face penalty charges and in some cases prosecution, under powers introduced by the Health Act 1999.
The penalty charge is a civil fine and may be imposed where a patient is found to have falsely claimed total or partial help with health costs. The penalty charge is five times the amount owed, up to a maximum of £100. This is in addition to the original charge. Payment will be pursued by civil recovery if necessary.
- A Quick Guide to Help with Health costs including NHS Charges and Optical Voucher Values (Leaflet HCS2)
- Help with Health Costs NHS Low Income Scheme application form HC1. To request a form call 0131 275 6386.
- Refund Claim NHS Low Income Scheme form HC5: for all health costs. To request a form call 0131 275 6386.
Health Costs Advice Lines
For further information about the NHS Low Income Scheme telephone 0300 330 1343.
NHS Tax Credit Exemption Certificates
Telephone enquiries to Patient Services of the BSA, please telephone: 0300 330 1347. Please have your tax credit award notice ready to answer questions.
The BSA does not deal with enquiries about tax credit applications or entitlement to an award notice. Any enquiries about entitlement to Tax Credit should go to:
HM Revenue & Customs – Tax Credit helpline
For enquiries about applications or entitlement to Tax Credit Award Notices: Tel: 0845 300 3900.
For people with hearing or speech difficulties: Tel: 0845 300 3909.
Other Health Advice
NHSScotland offers a 24-hour confidential nurse advice and health information service called NHS 24.
Telephone NHS 24 on: 111.
Please note: NHS 24 does not deal with tax credit queries.
NHS National Services Scotland, Practitioner Services Regional Offices
Ayrshire & Arran, Dumfries & Galloway, Greater Glasgow & Clyde, Lanarkshire and Western Isles:
NHS National Services Scotland
Practitioner Services (Medical)
5 Cadogan Street Glasgow G2 6QE
Borders, Fife, Forth Valley and Lothian:
NHS National Services Scotland
Practitioner Services (Medical)
1 South Gyle Crescent
Edinburgh EH12 9EB
Tel: 0131 275 6000
Grampian, Highland, Orkney, Shetland and Tayside:
Practitioner Services (Medical)
1 North Esplanade West
Aberdeen AB11 5QF
Tel: 01224 358400
Email: Elizabeth McLear