Your Rights

Health Benefits: getting help with NHS costs

Summary: How to get help with NHS costs

There are several different ways of qualifying for help with NHS costs. Some people automatically qualify for help with NHS costs. Other people qualify under the Low Income Scheme. Or you may be entitled to help because of certain medical conditions.

Do I automatically qualify for help with NHS costs?

You will qualify for help with

  • free sight tests
  • help towards the cost of glasses
  • free prescriptions
  • free dental treatment
  • help with fares to hospital

if you receive

or if you receive

If you are aged 60 or over, you automatically qualify for free prescriptions and free sight tests, and free dental examinations if you live in Wales.

If you are aged under 16, or under 19 and in full-time education, you can get free sight tests, vouchers towards the cost of glasses, and free prescriptions. If you are aged under 18, or under 19 and in full-time education, you can get free dental treatment.

If you have a war disability pension and need treatment because of the disability for which you get the pension, you are automatically entitled to health benefits. Contact

Service Personnel and Veterans Agency
Norcross
Thornton Cleveleys
Lancashire
FY5 3WP

Tel: 01253 330561
Email: veteransagency.fraud@spva.gsi.gov.uk

In Scotland and Wales, NHS sight tests and dental examinations are free for patients of all ages. To get help with paying for glasses or contact lenses and dental treatments you will have to qualify under one of the criteria listed above, under the Low Income Scheme or vouchers for glasses scheme (see below). Prescriptions are free to all patients of all ages in Wales.

Can I get help under the Low Income Scheme?

If you do not automatically qualify for help with NHS costs, you may be able to get either full or partial help with your NHS costs under the Low Income Scheme.

The amount of assistance given is worked out by comparing your "requirements" with your income. You may qualify for either full or partial help with your NHS costs.

To get help under the low income scheme, you (and your partner, if applicable) must not have more than £16,000 savings; or more than £21,500 if you are living permanently in residential or nursing care.

Can I get help with buying my glasses?

Registered blind and partially sighted people do not automatically receive help with buying glasses or contact lenses.

However you may receive a voucher to help pay for the glasses.

You will get a voucher if:

  • you are automatically entitled to health benefits
  • you qualify under the Low Income Scheme, either for full or partial help
  • you require complex lenses - the optometrist should tell you this and give you the relevant voucher
  • you attend a Hospital Eye Service because your glasses need changing frequently.

Are there other ways to qualify for free sight tests?

You can also qualify for a free NHS sight test if:

  • you are registered as blind or partially sighted
  • or you are diagnosed as having diabetes or glaucoma
  • or you are aged over 40 and are the parent, brother, sister or child of someone who has been diagnosed with glaucoma
  • or you need powerful or complex lenses (you will be told this)
  • or you are a patient of the Hospital Eye Service.

Further help with the cost of prescriptions

The other ways to qualify for help with prescriptions, apart from the criteria listed previously, are

  • you are pregnant or have given birth in the last 12 months
  • or you have one of a small number of specified medical conditions - this includes some types of diabetes
  • or you have a continuing physical disability which prevents you leaving your home without the help of another person. If this applies to you, you must get your GP to sign your application. It is important that you explain to your GP the difficulties you have getting out without the help of another person, eg finding directions, avoiding obstacles, crossing roads and keeping safe.

If you do not qualify for free prescriptions you may be able to reduce the cost of multiple prescriptions by obtaining a pre-payment certificate (PPC).

Apply for a PPC using form FP95 (EC95 in Scotland) available from chemists and GP surgeries, or (in England only) from Prescription Pricing Authority or the PPC order line on 0845 850 0030. You can also apply for a PPC online.

How do I claim health benefits?

  • If you qualify automatically due to your benefit entitlement or your age, complete the back of the prescription form or the appropriate form at the optician, dentist or hospital. You will usually be asked for evidence of how you qualify, eg Income Support award letter.

  • To claim free prescriptions: if you receive a qualifying benefit you will need to show the pharmacist your benefit award letter or your NHS tax credit exemption certificate.

  • To claim a Medical Exemption Certificate for a specified health condition ask your GP to complete form FP92A (EC92A in Scotland), which s/he will sign and send to the Exemption Issue Office. You will need to produce your certificate each time you pick up your prescription.

  • To claim a Maternity Exemption Certificate complete application form FW8. Your GP, midwife or health visitor is asked to sign the form and send it to the Exemption Issue Office. You will need to produce your certificate each time you pick up your prescription.

  • To claim under the Low Income Scheme: complete form HC1, which you can get from your local social security office, some GP's, dentists and opticians and send it to the Health Benefits Division. If you need help completing the form you can contact the Health Benefits Division on 0845 850 1166, or to request the form HC1 call the Health Literature line on 0800 555 777.

    If you are entitled to full help you will receive a HC2 certificate. If you can get partial help you will get a HC3 certificate. You can then present your certificate when paying for an item or service.

    The HC2 and HC3 certificates are normally valid for 12 months. There is no limit on the number of claims you can make.

  • To claim vouchers for glasses: ask for the voucher when your optician or hospital optometrist carries out the sight test. Supply evidence of how you qualify for help.

  • To claim fares to hospital: most hospitals have a department or person who deals with travel expense claims, eg finance department, cashiers or reception. You will need to present tickets / receipts along with evidence of how you qualify for help.

Can I claim a refund for an NHS health cost?

Yes. You can apply for a refund within three months if you were entitled to help with the health costs when you paid the charges.

Claim the refund for health costs (except prescriptions) on form HC5, which is available from social security offices and Post Offices. To claim a refund for prescription costs only complete form FP57 (EC57 in Scotland). Remember to enclose a receipt or other proof of payment.

Claims can also be made over the phone by contacting the Health Benefits Division on 0845 850 1166.

Further information

You can get the following leaflets about health benefits from your local social security office or the Health Benefits Line on 0845 850 1166.

For further information contact:

RNIB Welfare Rights Services
105 Judd Street
London
WC1H 9NE

Telephone: 0845 766 9999 for the price of a local call
Email: brit@rnib.org.uk

Back to Welfare Rights homepage

May 2007

Content author: brit@rnib.org.uk

Last updated: 09/06/2008 17:15

Print

More info

Quiz

When helping a blind person on steps you should:





Your stories

Jenny's story - Jenny Burgess volunteered for a disability support group run by people with physical disabilities. She was the only staff member with a sight problem. “I depended on a colleague with physical disabilities to give me a lift to work. I have far greater mobility problems than most people with physical disabilities who can drive a car, yet receive less benefit - it’s unfair and unjust.” Join our campaign to make the mobility component of the Disability Living Allowance fair - taken for a ride.