If you have a low income, you may be able to get help with NHS costs through the NHS Low Income Scheme (LIS).
The scheme covers:
You can apply for the scheme as long as your savings, investments or property (not including where you live) do not exceed the capital limit.
In England, the limit is:
- £23,250 for people who live permanently in a care home
- £16,000 for everyone else
Any help you're entitled to is also available to your partner and any dependant young people.
Depending on your circumstances, you can receive full help (HC2 certificate) or partial help (HC3 certificate).
You qualify for full help if your weekly income is less than or equal to your weekly requirements (a personal allowance to cover your day-to-day living expenses and housing costs), or is greater than your weekly requirements by no more than half the current NHS prescription charges.
If your income exceeds your requirements, you may be entitled to partial help. Your certificate will show how much you have to pay towards your health costs.
The rules governing who's eligible are broadly the same as those for a means-tested benefit. But the assessment also takes into account council tax and housing costs, so you can get help with health costs even if your income is too high for a means-tested benefit.
How to apply
There are 2 ways to apply for the NHS Low Income Scheme (LIS). You can apply online or by post.
To find out who can apply online, or to make an online application, go to the NHS Business Services Authority website.
To apply by post you'll need to complete an HC1 form and send it to the address on the form.
You can order an HC1 form online, or download an HC1 form from the NHS Business Services Authority website and print it yourself.
The form may also be available from your local Jobcentre Plus office or NHS hospital. A doctor, dentist or optician may also be able to give you one.
If you need help making your claim or have questions about the LIS, call 0300 330 1343. Telephone lines are open Monday to Friday 8am to 6pm, and Saturday 9am to 3pm.
Certificates are usually valid for between 6 months and 5 years, depending on your circumstances.
You do not need to apply if you or your partner:
- get Income Support
- get income-based Jobseeker's Allowance
- get income-related Employment and Support Allowance
- get Pension Credit Guarantee Credit
- are named on, or entitled to, a valid NHS tax credit exemption certificate – if you do not have a certificate, you can show your award notice; you qualify if you get Child Tax Credits, Working Tax Credits with a disability element (or both) and have income for tax credit purposes of £15,276 or less
- get Universal Credit and meet the criteria
These benefits or tax credits already entitle you to full help with health costs.
Formal reviews
If you're unhappy with the outcome of your claim, you can ask for a review by a service improvement adviser.
The service improvement team checks whether a claim has been correctly assessed in accordance with the regulations governing the scheme. If the decision was wrong, a new certificate will be sent to you.
You can request a review online via the NHS Business Services Authority website or post your request to:
NHSBSA
LIS Review Team
Help with Health Costs
Bridge House
152 Pilgrim Street
Newcastle upon Tyne
NE1 6SN
How to claim back money that you've already paid
You can submit a claim for a refund at the same time as you apply for the Low Income Scheme. Refund claims must be received within 3 months of the date on which you paid, or within 3 months of the date of your sight test.
To claim a refund of prescription charges, you'll need an NHS receipt and refund form FP57. Ask for the form when you pay for your prescription.
To claim a refund of other charges, including dental treatment, wigs and fabric supports, sight tests, glasses or contact lenses, and healthcare travel costs, you'll need the relevant HC5 form.
You can download the HC5 refund forms from the NHS Business Services Authority (NHSBSA) website:
Important numbers
NHS Low Income Scheme helpline – 0300 330 1343.
Prescription services helpline – 0300 330 1349.
Queries about medical exemption certificates – 0300 330 1341.
Queries about prescription prepayment certificates (PPCs) – 0300 330 1341.
Queries about tax credit certificates – 0300 330 1347.
Call 0300 330 1343 for all other queries.