NHS Costs

Help with NHS costs can cover prescription charges, dental charges, hospital travel costs and the costs of glasses and eye tests.

There are three ways to qualify for help:

  • automatic qualification due to claimants age or specific circumstances
  • receipt of a qualifying benefit
  • qualifying on low income grounds.

Automatic Exemption

The following people are automatically entitled to free prescriptions by completing the reverse of the prescription:

  • aged under 16 years, (Under 25 in Wales only) or under 19 years in full time education
  • aged 60 years or over

The following people are automatically entitled to free prescriptions, but need to obtain an exemption certificate:

  • expectant mothers
  • women who have had a child during the last year
  • people who have a specified condition
  • people who are housebound with a continuing disability
  • war/service pensioners for prescriptions for their war disability
  • residents of residential care or nursing homes funded wholly or partly by the local authority

The following people are automatically entitled to free NHS dental treatment, by ticking the box on the form provided by the dentist:

  • aged under 16 years (for treatment, dentures or bridges)
  • aged under 18 years (for treatment)
  • aged under 19 years in full-time education (for treatment, dentures or bridges)
  • expectant mothers
  • women who have given birth during the last 12 months
  • war/service pensioners for treatment needed because of their war disability
  • residents of residential care or nursing homes funded wholly or partly by the local authority

The following people are automatically entitled to full help with fares to attend disablement services centre or a NHS hospital for treatment:

  • those receiving treatment at a sexually transmitted disease clinic more than 15 miles from their home
  • war/service pensioners for treatment needed because of their war disability
  • residents of residential care or nursing homes funded wholly or partly by the local authority

The following people are automatically entitled to free eye tests and vouchers for glasses:

  • aged under 16 years, or under 19 years in full-time education
  • registered partially sighted
  • diagnosed as suffering from diabetes or glaucoma
  • aged 40 or over and are the parent, brother, sister or child of someone suffering from glaucoma
  • war/service pensioners who require a sight test because of their war disability
  • patients of the Eye Hospital Service

Qualifying Benefits

If the claimant or a member of their family receives one of the following benefits, they will qualify for free prescriptions, free dental treatment and dentures, free sight tests and vouchers for glasses and full help with fares to attend a disablement services centre or a NHS Hospital for treatment.

  • Income Support
  • Income based Jobseeker's Allowance
  • Guaranteed Credit part of Pension Credit
  • Child Tax Credit
  • Child Tax Credit and working tax credit
  • Working Tax Credit including a disability element

Low Income Grounds

Full or partial help with NHS costs for prescription charges, dental charges, hospital travel costs and the cost of glasses and eye teats may be available to people who have a low income.

For help on low income grounds claimants must complete form HC1, which is available from doctors' surgeries, dentists, opticians, hospitals, advice agencies or Benefit Agency offices.

Claimants must have less that £8,000 capital.

The Benefits Agency carries out an assessment of the claimant's 'requirements' against their 'resources' to decide if they qualify on low income grounds.

The claimant's 'requirements' are worked out by adding up the following:

  • Claimant's Income Support personal allowances or Pension Credit allowances
  • Claimant's Income Support premiums or Pension Credit allowances
  • Claimant's rent less any Housing Benefit
  • Claimant's council tax less any Council Tax Benefit
  • Claimant's housing costs

If the claimant qualifies for free services they will receive a certificate HC2.

If the claimant qualifies for partial reduction in charges they will receive certificates lasting for up to 12 months from the date of the claim.

There is no right of appeal against a decision, but a request could be made to look at the claim again if a mistake has been made.

Back