Healthcare Travel Costs Scheme: getting hospital fares refunded

What the scheme pays back

The Healthcare Travel Costs Scheme, or HTCS, refunds what you spend getting to NHS care you were referred for. In England most hospitals pay claims at a cashier's office, your integrated care board (ICB) sets local rules such as the mileage rate, and postal claims go on form HC5(T) to the NHS Business Services Authority (NHSBSA) or another office the form names. The refund is based on the cheapest suitable transport for you, which the NHS website says is usually public transport.

The scheme can cover:

• bus, coach, tram and train fares
• fuel for a car, repaid at the mileage rate your local ICB uses
• unavoidable car parking and toll charges
• congestion charge or ULEZ charges, which patients in London may be able to claim
• a taxi, when the hospital or ICB agreed to it before you travelled
• travel from your home to the station, port or airport where a journey to NHS treatment abroad starts

No national mileage figure is published. Each ICB uses its own rate. Ask the cashier's office for the local figure before you rely on the car.

Leaflet HC11 adds one fixed figure. If you live on the Isles of Scilly, £5 is the most you pay to reach NHS care on the mainland after a referral.

Who qualifies in England

The NHS website sets three conditions. You or your partner, including a civil partner, get a qualifying benefit or meet the Low Income Scheme rules. A healthcare professional has referred you to a specialist or hospital for further NHS treatment or tests. The appointment is on a separate visit from the one where the referral was made.

Form HC5(T) lists the routes to entitlement:

• Universal Credit, where the last complete assessment period before you paid showed no earnings or net earnings of £435 or less (£935 if you had a child element or limited capability for work)
• Income Support
• income-based Jobseeker's Allowance
• income-related Employment and Support Allowance
• Pension Credit Guarantee Credit
• an HC2 certificate for full help, or an HC3 for partial help
• a War Pension or Armed Forces Compensation Scheme payment, when the treatment is for the accepted disablement

An HC3 states how much help you get, so you may still pay part of each fare. People aged 16, 17 or 18 who are not part of a family on benefits can claim on their own low income. Anyone else on a low income without a certificate applies on form HC1 through the NHS Low Income Scheme.

Journeys the scheme refuses

The NHS website names three exclusions. Visiting someone in hospital does not count. Routine primary care such as check-ups, vaccinations and cervical screening does not count. Urgent primary care in out-of-hours periods does not count either.

Private treatment you pay for yourself is outside the scheme. NHS-funded care given in a private hospital is inside it, and form HC5(T) tells you to send those claims to the ICB for your address.

Cheapest reasonable transport

The test is personal. The NHS website names three factors: your age, your medical condition and whether public transport is available. A condition affecting your mobility can make the car the reasonable choice. A direct bus at the right time usually makes the bus fare the benchmark. When you are unsure, ask the hospital or ICB before the journey rather than afterwards.

Companions and children

A companion's fares are added to yours when a healthcare professional says it is medically necessary for someone to travel with you. The NHS website says these payments depend on the patient's eligibility, regardless of the companion's own income. You can claim for an eligible child who has been referred, and some ICBs accept claims from the parent or guardian of a child under 16 who has to attend with them.

How much you get back

Every pound of the cheapest reasonable fare comes back with an HC2 or a qualifying benefit. As an illustration, take a £9.20 return train fare to weekly treatment for 8 weeks. You pay £73.60 in fares. If a healthcare professional says you need a companion, their tickets double the claim to £147.20, all refundable. With an HC3, the certificate itself sets how much of the cost you get back.

How to claim

1. Before the journey, agree any taxi with the hospital or ICB, and ask about an advance payment if you cannot afford the fare up front.
2. Keep every ticket and fuel receipt.
3. On the day, take the receipts, your appointment letter or card and proof of your benefit or certificate to the hospital's nominated cashier's office. Reception or the Patient Advice and Liaison Service (PALS) can tell you where it is.
4. If the place treating you does not pay out, for example a GP practice or dental surgery you were referred to for specialist treatment, complete form HC5(T).
5. Post the form. The NHSBSA does not accept travel refund claims by email. The form names the right address for your group, from the hospital itself to your Jobcentre Plus office, the Pension Centre or NHSBSA at Bridge House, 152 Pilgrim Street, Newcastle upon Tyne NE1 6SN.
6. Make sure the form arrives within 3 months of the date you paid. A later claim needs a written explanation, and the NHSBSA decides whether the delay had a good reason.

Scotland, Wales and Northern Ireland

Scotland: NHS inform says help covers necessary travel costs for people getting Income Support, income-based JSA, income-related ESA, Pension Credit Guarantee Credit or an NHS Tax Credit Exemption Certificate, for Universal Credit claimants who meet the rules, and for people entitled through the Low Income Scheme. A companion is added for medical reasons. If you live in Highland, Argyll and Bute, the Western Isles, Orkney or Shetland and travel at least 30 miles (48 km), or more than 5 miles (8 km) by sea, to reach hospital, a set maximum applies to what you pay. Claims use the Scottish HC5 form from a GP practice or pharmacy.

Wales: the Welsh Government covers travel to NHS treatment under the care of a consultant, by the cheapest means reasonable for you. A companion counts when your consultant decides you need one. The hospital usually refunds you when you attend. Otherwise you use form HC5W(T), which you can order on 0345 603 1108.

Northern Ireland: the Hospital Travel Costs Scheme pays the cost of the cheapest public transport, or petrol up to the equivalent public transport fare, at a mileage rate the hospital gives you. Qualifying benefits include income-related ESA and Guarantee Pension Credit, and people on a low income apply on form HC1. You claim at the hospital or clinic at the time of the appointment and are paid in cash. A later claim on form HC5 is allowed up to three months after the appointment.

Mistakes that cost money

Taking a taxi without agreement. The claim falls back to the bus or train fare and you pay the difference.

Throwing away tickets. The NHSBSA asks for tickets or fuel receipts with an HC5(T) claim.

Waiting for the HC2 to arrive and then forgetting the journeys before it. Leaflet HC11 says you pay first and claim when you have evidence of entitlement, so keep receipts from the start.

Claiming for a relative's visits. Visiting is excluded even when the patient qualifies.

Where the figures come from

The three conditions, the exclusions, mileage, parking, tolls, taxis, London charges, advance payments, escorts and the cashier's office are from the NHS website HTCS page. The list of benefits, the £435 and £935 limits, the age 16 to 18 rule, the 3-month limit and the postal addresses are from form HC5(T), June 2025. The rule against email claims is from the NHSBSA apply for a refund page. The companion rule, the £5 Isles of Scilly maximum and the advice to pay first and claim later are from leaflet HC11, April 2026. The Scottish rules are from NHS inform, the Welsh rules from the Welsh Government travel costs and HC5W(T) pages, and the Northern Ireland rules from nidirect. The £9.20 fare in the example is an illustration, not a published price.