Publication - Advice and guidance

Help with health costs: information booklet

Published: 23 Nov 2018
Directorate:
Population Health Directorate
Part of:
Equality and rights, Health and social care
ISBN:
9781788514248

Information booklet (HCS1) providing advice on what help a person may be entitled to for NHS charges.

40 page PDF

183.1 kB

40 page PDF

183.1 kB

Contents
Help with health costs: information booklet
Income Groups

40 page PDF

183.1 kB

Income Groups

Income Support

You get free:

  • NHS dental treatment.

You also get:

  • a voucher towards the cost of glasses or contact lenses;
  • refunds of necessary travel costs to and from hospital for NHS treatment for you, your partner and any dependent children and young people under 20.

If you are waiting for your Income Support claim to be settled and need help urgently with any health costs – read pages 20-22 (see pdf for page numbers).

Income-Related Employment And Support Allowance (ESA(IR))

If you get ESA(IR) paid on its own or with contribution-based ESA you are entitled to the same help with health costs as people getting Income Support (see above).

Contribution-Based Employment And Support Allowance – (ESA(C))

IMPORTANT: On its own, ESA(C) does not entitle you to help with health costs. If you have to pay health costs, check to see if you are in any of the groups listed on pages 4 and 5 (see pdf for page numbers). Or you might be able to get help if you are on a low income – read pages 20-22 (see pdf for page numbers).

If you are not sure about the type of ESA you are getting, ask at your Jobcentre Plus office.

If you are waiting for your ESA claim to be settled and need help urgently with any health costs – read pages 20-22 (see pdf for page numbers).

Pension Credit Guarantee Credit

If you:

  • get Pension Credit Guarantee Credit;
  • get Pension Credit Guarantee Credit with Savings Credit; or
  • are aged under 60 and your partner gets Pension Credit Guarantee Credit;

you are entitled to the same help with health costs as people getting Income Support or income-related Employment and Support Allowance – see page 14 (see pdf for page numbers).

How to check if you are getting Pension Credit Guarantee Credit

Your payment book (if you have one) is simply marked ‘Pension Credit’. Only your award notice tells you what type of Pension Credit you get. This is shown on the page entitled ‘How your Pension Credit has been worked out’. If you have not received an award notice or have mislaid it, you should ring the Pension Service on Freephone 0800 991234 and ask for a copy.

IMPORTANT: If you get Pension Credit Savings Credit paid on its own, this does not entitle you to help with health costs. If you have to pay health costs, check to see if you are in any of the other groups listed on pages 4 and 5 (see pdf for page numbers). Or you might be able to get help if you are on a low income – read pages 20-22 (see pdf for page numbers).

Income-Based Jobseeker’s Allowance (JSA(IB))

If you get JSA(IB) paid on its own or with contribution-based JSA you and your partner are entitled to the same help with health costs as people getting Income Support – see page 14 (see pdf for page numbers).

Contribution-based Job Seeker’s Allowance (JSA(C))

IMPORTANT: On its own, JSA(C) does not entitle you to help with health costs. If you have to pay health costs, check to see if you are in any of the groups listed on pages 4 and 5 (see pdf for page numbers). Or you might be able to get help if you are on a low income – read pages 20-22 (see pdf for page numbers).

If you are not sure about the type of JSA you are getting, ask at your Jobcentre Plus office.

If you are waiting for your JSA claim to be settled and need help urgently with any health costs – read pages 20-22 (see pdf for page numbers).

Universal Credit

If you get Universal Credit:

  • and had no earnings or net earnings (take-home pay) of £435 or less during the most recent assessment period; or
  • which includes an element for a child and/or limited capability for work or limited capability for work related activity, and had no earnings (take-home pay) or net earnings of £935 or less during the most recent assessment period;

you are entitled to the same help with health costs as people getting Income Support – see page 14 (see pdf for page numbers).

Your assessment period will run for a calendar month from the date of your claim for Universal Credit (which will be shown on your award notice), and between the same dates each month after that.

Other Benefits

Only Income Support, Income-related Employment and Support Allowance, Pension Credit Guarantee Credit, Universal Credit and in your last assessment period you had no earnings, or earnings within the allowed limit, or Income-based Job Seeker’s Allowance count for automatic help with health costs.

Other benefits such as Incapacity Benefit, Contribution-based Employment and Support Allowance, Contribution-based Jobseeker’s Allowance, Attendance Allowance, Personal Independence Payment and Disability Living Allowance don’t count. If you have to pay health costs, check to see if you are in any of the other groups listed on pages 4 and 5 (see pdf for page numbers). Or you might be able to get help if you are on a low income – see pages 20-22 (see pdf for page numbers).

If you are not sure what type of benefit you are getting, ask at your Jobcentre Plus Office.

Tax Credits

There are two types of tax credit:

  • Working Tax Credit (WTC)
  • Child Tax Credit (CTC)

If you meet the following conditions, you automatically qualify for full help with health costs. You get:

  • WTC and CTC;
  • WTC on its own which includes a disability element or severe disability element – check your award notice or decision letter; or
  • CTC on its own.

In each case, your family income for tax credits must be £15,276 or less. This is on your tax credit award notice or decision letter sent to you by HM Revenue and Customs (HMRC).

If you meet the qualifying conditions you can get:

  • free NHS dental treatment;
  • a voucher towards the cost of glasses or contact lenses;
  • a voucher towards the cost of repair of glasses, if under 16, or if over 16 and in accordance with certain conditions (see page 23) (see pdf for page numbers);
  • refunds of necessary travel costs to and from hospital for NHS treatment for you, your partner or any dependent children and young people under 19.

HMRC issues tax credit award notices that tell families they might be entitled to other help. Only HMRC can say whether or not you are eligible for WTC or CTC.

If you are unsure about the amount of your income for tax credit purposes, you can check this with HMRC Helpline on: 0845 300 3900.

For people with hearing or speech difficulties the helpline number is 0845 300 3909.

If you have made a claim but not yet received your tax credit award notice you should contact HMRC.

NHS Tax Credit Exemption Certificates

If you meet the qualifying conditions you will be sent an NHS Tax Credit Exemption certificate. This will be sent automatically, you do not need to apply for one. Use your certificate as evidence of entitlement to help when you go for treatment.

Patient Services of the Business Services Authority – an NHS body based in Newcastle – sends out NHS Tax Credit Exemption Certificates on behalf of the Health Departments in England, Scotland, Wales and Northern Ireland.

HMRC will send information to the BSA each month about families who are entitled to a certificate. The BSA cannot send you an exemption certificate until they receive the information from HMRC.

If you meet the qualifying conditions, as explained on page 17 (see pdf for page numbers), for help through your tax credits you can sign NHS treatment forms to say you don’t have to pay because you get tax credit. Use your award notice or decision letter as evidence of your entitlement until your exemption certificate arrives.

If you pay and subsequently find that you qualify for help you can claim a refund on form HC5, available from your dentist or optician, NHS hospital or Jobcentre Plus office. You can only get a receipt at the time you pay the charge.

If you are still unsure about whether or not you are entitled to an NHS Tax Credit Exemption Certificate, ring the BSA on 0300 330 1347 and have your Tax Credit Award notice ready so you can tell them what is on it.

If you lose your NHS Tax Credit Exemption Certificate

Tell the BSA by writing to:

NHS Help with Health Costs
Bridge House
152 Pilgrim Street
Newcastle upon Tyne
NE1 6SN

and let them know what happened. They will send you a duplicate.

If you do not qualify for help through tax credit exemption

Tax credit exemption is for people who are working, or are disabled, or who have children.

If you do not qualify for help through tax credits you may be able to claim help through the NHS Low Income Scheme – read pages 20-22 (see pdf for page numbers).

You can also phone HMRC Helpline 0845 300 3900 for advice about other help that might be available through tax credits.

For people with hearing or speech difficulties the helpline number is 0845 300 3909.

The NHS Low Income Scheme

If you have to pay for any of the items listed on page 4 (see pdf for page numbers) of this document, and are not getting any of the qualifying benefits listed on pages 14-19 (see pdf for page numbers), the NHS Low Income Scheme may be able to help you with the cost. This scheme provides help for people on low incomes and anyone may make a claim, including people who are working or who are students.

Your entitlement to help through the Low Income Scheme is worked out by comparing your income to your needs. Your needs include a personal allowance for day-to-day living expenses, premiums for special circumstances, housing costs (for example, rent or mortgage payments, including capital repayments – the repayment which covers the main amount borrowed not the interest) and council tax.

If you have a partner, their income, savings, property and needs are counted with yours. A partner is a person you live with as part of a couple of the same or opposite sex, whether or not you are married or have a civil partnership.

If you have capital (saving, or the value of a property you don’t live in) which is more than £16,000, or £23,250 for people who live permanently in a care home, you cannot get any help through the Low Income Scheme.

If a dependent child under 16 has to go to hospital for NHS treatment, you can claim help with their travel costs (if you are not already getting a qualifying benefit); it’s your income that counts.

If you would like to find out if the scheme can help you, pick up an HC1 form (claim for help with health costs) from a Jobcentre Plus office or NHS hospital. Your dentist or optician may have copies too or ring 0131 275 6000 to get a copy by post.

You can fill in a special short claim form, the HC1(SC) if one of the following applies to you:

  • you live permanently in a care home and the local authority helps you with the cost; or
  • you are supported by the local authority because you are aged 16 or 17 and recently left local authority care.

Ask your home manager/local authority/care worker for an HC1(SC) claim form. Otherwise, use the normal form, the HC1.

If you are aged 16 or over you can make your own claim on an HC1, but you needn’t do this if you count as a dependant of someone who is getting a qualifying benefit or tax credit (read pages 14-19) (see pdf for page numbers), because their benefit or tax credit award includes you.

Fill in the HC1 or HC1(SC) and send it off in the envelope that comes with it. The claim form tells you what to do and may ask you to send in evidence of your income.

If you have any queries about how to fill in these forms, or what to send, you can call Patient Services of the Business Services Authority on 0300 330 1343, or write to:

NHS Help with Health Costs
Bridge House
152 Pilgrim Street
Newcastle upon Tyne
NE1 6SN

Patient Services uses the information you have supplied to work out how much help you might get towards your health costs. The HC1 tells you more about this and explains what counts as income.

NHS Low Income Scheme Certificates

If you qualify for help you will be sent an NHS certificate HC2 which entitles you to full help or an NHS certificate HC3 which entitles you to partial help with health costs. The certificate will tell you who it covers, what help is provided and how long it lasts.

If you need help urgently with any health costs while you are waiting for Income Support, Income-related Employment and Support Allowance, Income-based Jobseeker’s Allowance, Pension Credit or tax credits to be awarded, make a separate claim on a Low Income Scheme form HC1. Don’t wait for your benefit or credit claim to be settled. But if you have a tax credit award notice – read pages 17-19 (see pdf for page numbers) to see if you can get help without making a low income claim.

If you need emergency NHS dental treatment, or don’t want to delay your NHS treatment or wait for your glasses or contact lenses to be repaired or replaced (read pages 31-32) (see pdf for page numbers) you will need to pay and claim a refund later.

If you want to claim a refund of any health cost – read pages 31-32 (see pdf for page numbers), ‘How To Claim A Refund’.

People seeking asylum who are supported by the National Asylum Support Services will be sent an NHS Charges Certificate (HC2) for full help along with their first support payment. Also – read page 27 (see pdf for page numbers), ‘People From Abroad’.


Contact

Email: Elizabeth McLear