NHS Low Income Scheme: HC1 form, HC2 and HC3 certificates

What the scheme is

The NHS Low Income Scheme is an income-tested route to help with NHS charges for people who are not already exempt through age, a benefit or a medical condition. The NHS Business Services Authority (NHSBSA) runs it for England, Scotland and Wales. Northern Ireland runs a parallel scheme through Jobs & Benefits offices. The outcome is a certificate: HC2 for full help, HC3 for partial help.

What it covers

The NHSBSA lists five types of cost:

• NHS prescription charges, £9.90 an item in England. HC2 only.
• NHS dental treatment charges.
• Sight tests, glasses and contact lenses.
• Travel costs to receive NHS treatment under a referral.
• NHS wigs and fabric supports, subject to the hospital's own arrangements.

An HC2 makes all of these free or refunded in full. An HC3 states a weekly amount you must pay before help starts and the NHSBSA knowledge base confirms an HC3 does not give free prescriptions.

Who qualifies

The test has two parts. First, capital. You and your partner together must hold £16,000 or less in savings, investments and property, not counting the home you live in. For permanent care home residents the limit is £23,250 in England and Scotland and £24,000 in Wales. Above the limit the application is refused whatever your income.

Second, income. The NHSBSA compares your weekly income with your weekly requirements, meaning personal living costs plus housing costs. Income at or below requirements, or above them by up to half the English prescription charge (£4.95), gives full help and an HC2. Income further above requirements gives partial help and an HC3, with the excess setting what you pay.

You do not need to apply if you already get full help. That covers people on Income Support, income-based Jobseeker's Allowance, income-related Employment and Support Allowance, Pension Credit Guarantee Credit, and Universal Credit with take-home pay of £435 or less (£935 with a child element or limited capability for work). Dependent children under 20 on those claims are covered too.

How to apply

1. Decide between online and paper. The online service at apply-for-help-with-nhs-costs.nhsbsa.nhs.uk takes applications from people with £6,000 or less in capital. It refuses the self-employed, apprentices, students with funding beyond a loan, people with a second property, people receiving fostering income, maintenance or trust fund payments, couples where either receives Asylum Support, and permanent care home residents without local authority help.
2. If paper, get form HC1. In England, order one online for posting (it arrives within 15 working days) or download and print the PDF from the NHSBSA website. In Scotland, download it or collect one from a Jobcentre, GP practice, pharmacy or Citizens Advice. In Wales, download it from GOV.WALES or ring 0345 603 1108 and pick the health publications option. In Northern Ireland, download it from nidirect or collect one from a Jobs & Benefits office, GP, dentist, pharmacist, optician or hospital. Care home residents and 16 to 17 year olds leaving care use the short HC1(SC).
3. Gather evidence. Employed applicants send the 5 most recent payslips if paid weekly or fortnightly, or 2 if paid monthly or four-weekly, or form LIS82 if payslips are unavailable. Self-employed applicants send profit and loss accounts covering at least 6 months ending within the past 12 months, or a trading account, plus form LIS61. Students send evidence of grants, bursaries and awards and the student loan financial assessment.
4. Post the HC1 and evidence to NHS Help With Health Costs, Unit 5, Greenfinch Way, Newcastle upon Tyne, NE15 8NX. It is not a freepost address, so use a stamp. In Northern Ireland hand the form to a Jobs & Benefits office.
5. Wait. The NHSBSA says certificates are normally issued within 4 weeks and that assessment normally takes 18 working days. Ring 0300 330 1343 for help with the claim.

How long it lasts

The NHSBSA states certificates are usually valid for between 6 months and 5 years depending on circumstances. The end date is printed on the certificate. In Northern Ireland the HC2 and HC3 each run for 12 months. The NHSBSA does not renew automatically. Send a new HC1 before the expiry date to keep cover running. A review of a decision you think is wrong goes to 0300 330 1343 or in writing to the Low Income Scheme with your certificate number, name, date of birth, address and a short explanation.

Costs paid before the certificate came

Refunds run backwards for 3 months from the date of payment or the sight test. The NHSBSA lets you claim at the same time as applying. For a prescription you need form FP57, issued only at the moment of paying. For dental treatment use HC5(D), for sight tests and glasses HC5(O), for travel HC5(T) and for wigs HC5(W). Travel and wig claims go by post only. The prescription refund guide walks through each form.

Mistakes that cost money

Sending the HC1 without payslips. The NHSBSA cannot assess income without evidence and the form comes back, which pushes the start date later.

Assuming the HC3 makes prescriptions free. It does not. HC3 holders pay the full £9.90 and should consider a prepayment certificate if they collect 12 or more items a year.

Letting the certificate expire. Help stops on the printed end date. A claim on an expired HC2 is treated as a wrong claim and can lead to a penalty charge.

Applying when already exempt. People on the qualifying benefits listed above waste the form. The NHSBSA checker shows in about three minutes whether you already have full help.

Where the figures come from

The capital limits, covered costs, income test, 18-working-day assessment, 4-week issue time, 6-month to 5-year validity, address and phone numbers are from the NHSBSA Low Income Scheme page. The online application exclusions, the £6,000 online limit and the 15-working-day posting time are from NHSBSA knowledge base article KA-03896. The evidence list and the Newcastle postal address are from the NHSBSA page for people who cannot apply online. Refund forms and the 3-month limit are from the NHSBSA apply for a refund page. The HC1(SC) short form is listed in leaflet HC11 (V28). The 12-month validity in Northern Ireland is from nidirect.