NHS Low Income Scheme under 60s

NHS Low Income Scheme: Under 60's

What is it?

The Low Income Scheme provides income related help to people who are not exempt from charges but who may be entitled to full or partial help if they have a low income.
The NHS Low Income Scheme covers:

  • NHS prescriptions
  • NHS dental treatment
  • Sight tests, glasses and contact lenses
  • Travel to receive NHS treatment
  • NHS wigs and fabric supports

The scheme is designed so that you can claim for a certificate before you need any treatment and are able to budget accordingly.
However, if you’ve already paid for something, you can apply for a refund at the same time you apply for a certificate.

You may qualify for a HC2 certificate which gives full help with the health costs listed above, or a HC3 certificate which gives limited help, the certificate will tell you what you have to pay.

Can I get it?

Anyone can apply as long as they don't have savings above the capital limit.

In England and Scotland the capital limit is:

  • £23,250 for those permanently in a care home
  • £16,000 for everyone else

In Wales the capital limit is:

  • £24,000 for those permanently in a care home
  • £16,000 for everyone else

Any help you are entitled to is extended to your partner as well, if you have one.

Help is based on a comparison between your weekly income and assessed requirements at the time the claim is made (or the date the charge was paid if a refund is claimed).

Entitlement broadly follows Income Support rules to decide how much, if anything, you have to pay towards your health costs. The scheme also allows us to include your council tax and housing costs in the assessment. This means you can get help with your health costs even if your income is too high for Income Support.

Children under 18, and young people aged 18 and 19 in full-time education*

You get free:NHS prescriptions, NHS dental treatment for any course of treatment that starts before your 18th birthday or, if you are in full-time education, your 19th birthday, NHS sight tests and NHS wigs and fabric supports. You also get vouchers towards the cost of glasses or contact lenses, may get vouchers towards the cost of repair or replacement of glasses or contact lenses and may get help with travel costs for NHS treatment.

*Full-time education means you must be receiving full-time instruction from a recognised educational establishment, such as a school, college or university. To be a ‘recognised establishment’ the place where you are studying must have a Department for Education and Skills (DfES) Establishment Number, and be registered on the DfES database. If it is not registered with the DfES, you still may be able to claim for help with health costs if you have a low income.

Young people aged under 25 living in Wales

You get free NHS dental examinations carried out in Wales before your 25th birthday. 

How do I claim?

To find out if the NHS Low Income Scheme can help you, fill in an HC1 form (claim for help with health costs) or HC11 in Northern Ireland.
You do not need to fill in an HC1 if you, or your partner if you have one, are:

  • getting Income Support
  • getting income-based Jobseeker's Allowance
  • getting income-related Employment and Support Allowance
  • getting Pension Credit Guarantee Credit
  • named on, or entitled to, an NHS Tax Credit Exemption Certificate

as the benefit or tax credits you or your partner gets already entitles you to full help with health costs.

What happens after I claim?

You will qualify for a full help with health costs HC2 certificate (which includes free NHS prescriptions), if your income is less than or equal to your requirements, or your income is greater than your requirements by no more than half the current English prescription charge.

You will qualify for a limited help with health costs HC3 certificate if your income is greater than your requirements by more than half the current English prescription charge. The HC3 certificate which shows how much you have to pay towards your health costs.

Certificates are usually valid for periods of between six months to five years, depending on your circumstances.

More information on the NHS low income scheme is available via the NHS costs helpline 0300 330 1343 or the NHS website or for Northern Ireland the  NIdirect website.

 

Scroll To Top