Health

NHS Low Income Scheme 2022: how to get this benefit

8 December 2022 by Robin - 8 minutes of reading time

nhs low income scheme 2022

What is the NHS Low Income Scheme? Am I eligible? How do I apply? This scheme is a benefit that can help paying for health costs. This Your Benefits article will walk you through all you need to know about this financial aid.

What is the NHS Low Income Scheme?

If you currently receive low income, you might be eligible to receive help with health costs and other expenses through the NHS Low Income Scheme. This includes:

The amount of help you are eligible for might depend on multiple factors, like your weekly income, necessary outgoings and savings. You may also receive financial help from the scheme if you have already received an eligible treatment.

Then, you can be claiming a refund at the same time that you send your application for the scheme. This means that you could get paid back and get NHS Low Income Scheme.Usually, your application will be assessed within 18 days of the NHS receiving your form.

NHS Low Income Scheme income limit

You may apply to the NHS Low Income Scheme if you do not own capital, savings, investments or properties above £6,000. To be eligible, you must be one of the following:

  • A student;
  • A pensioner;
  • Earning a wage;
  • Receiving state benefits;
  • Living in a care home.

NHS Low Income Scheme income limit

You may not receive help if you, your partner or both of you have more than:

  • £16,000 in savings, investments or property, excluding the property in which you live;
  • £23,250 in savings, investments or property if you stay in a care home permanently (if you live in Wales, this amount is £24,000).

How to apply for NHS Low Income Scheme

If you live in England, you have two options. You can either print an HC1 form from online, or order one from online to apply for the scheme. If you live in Scotland, you can print an HC1 form from online, or get one from Jobcentres, General Practitioners practices and Citizens Advice.

Disclaimer
If you live in Wales, you can visit the Welsh Government Website and print an HC1 form from online. You can also have a form sent to you. Simply call 0345 603 11108, and choose the option for health publications. You can also visit a Jobcentres, NHS hospital, dentist or optician to receive an HC1 form.

If you would list assistance in making your claim, you can call the NHS at 0300 330 1343.

You may send your HC1 form to the following address, with a stamp:

Bridge House
152 Pilgrim Street
Newcastle upon Tyne
NE1 6SN

Important
Do you already have an HC2 or HC3 certificate? If you wish to renew your NHS Low Income Scheme, you will need to complete and send a new HC1 form regardless.

Can I get NHS Low Income Scheme automatically?

You might already be entitled for full help with your health costs. If so, you do not need to apply the NHS Low Income Scheme. Do not worry about applying if you or your partner already receives one of the following:

  • Income-based Jobseeker’s Allowance (JSA);
  • Income-related Employment and Support Allowance (ESA);
  • Pension Credit Guarantee Credit;
  • Universal Credit (if you earned £435 or less during your last complete assessment period, or £935 or less, if you had limited work capabilities or had a child element);
  • Income Support.

This also applies to you if you are noted on or entitled to an NHS tax credit exemption certificate or prepayment certificate. This is if the family income used in calculating your Tax Credits totalled £15,276 or less, and you are a recipient of one of the following:

If you have dependent children under 20 included on your benefit or tax credit claim, they are entitled to the same help.

Proof for application

If you are employed, you will need to provide proof of your earnings with your HC1 form to get the NHS Low Income Scheme. The number of payslips you will need to include depends on how you are paid:

  • If you are paid weekly or fortnightly: you will have to include your 5 most recent payslips;
  • If you are paid monthly or four-weekly: you will have to include your 2 most recent payslips.
Are you unable to provide your payslips with your application? In this case, you will need to print and complete LIS82 proof of income form, and include it in your application. This form will need to be completed partially by an employer. It informs the NHS of what your income is, in the absence of payslips.

If you are self-employed, you will need to include your profit and loss accounts for at least the past 6 months. They must cover a period that ends within the past 12 months of your application. If you are applying for a refund, it must be within 12 months of the date that the charges were paid.

If you are unable to include your profit and loss accounts, there is an alternative. You may include a trading account instead. It must display your business receipts and expenses, and the period must end within 12 months before the date that you are applying.

You also need to complete and include self-employment proof of income form LIS61 in your application. This form will inform the NHS of your business expenses. The assessment period will be adapted accordingly if your business started trading less than a year ago, or the trading pattern changed.

Can I receive a refund if I paid for treatment before applying?

NHS Low Income Scheme student proof

If you are a student, you will need to include evidence for various financial information. First, any grants, bursaries and awards that you are currently receiving. To do so, you may include an award notice, that indicates how much money you are receiving.

Then, if you applied for a student loan, you must include a copy of the financial assessment that was done. This is needed for your application, whether or not the loan was actually awarded to you.

Please note that, in your assessment, the total amount of student loan available to you will be counted as income, for both the income-assessed and non-income assessed loan elements. This applies whether or not an application was done for both. Additionally, the same applies for any assessed contributions to the loan, whether or not they were paid.

NHS Low Income Scheme refund before applying

Yes, however, you will need to do so within 3 months of the date you were charged, or had a sight test.

For prescription refunds, you will need to ask for an NHS receipt form FP57 to your pharmacist, hospital or doctor. You will need to do so when you pay, as you cannot ask for one afterwards.

For other health costs, you will have to complete and send an HC5 form to the NHS. The form you will complete depends on the country you are currently residing in.You may find the forms that you need to complete on the NHS website.

How will the NHS assess my form?

When the NHS assesses how much money you may receive, they do so by looking at your income. They compare how much money you receive weekly with your requirements, or your weekly needs. In other words, they calculate the amount of money you would need to cover your health costs compared to the amount of money you are actually receiving right now.

What are weekly requirements? They are a personal allowance meant to portray how much money you require for certain basic expenses. Such expenses are daily living expenses, as well as housing costs you are liable to pay (like Council Tax, rent and mortgage).

You will receive full help if one of the following applies to your income:

  • It is the same or less than your living requirement;
  • It is more than your living requirement, but up to half of the cost of a prescription in England.

Here is an example to portray how your application is assessed.

NHS Low Income Scheme claim assessment example
Name  Amount of money
Income £120.76 a week
Weekly requirements £123.47 a week
Difference -£2,71

In this situation, the person qualifies for full help. Because their income is less than their weekly requirements, they qualify for full help. As such, the NHS will help in covering health costs fully.

What happens after I apply?

If you are eligible, you will receive one of the following. They should be delivered to you within 4 weeks of applying. Depending on your circumstances, they will be valid anywhere between 6 months and 5 years.The NHS will typically get to your application within 18 working days of the date your form was received.

  • An HC2 certificate if you are eligible for full help with health costs (including free NHS prescriptions);
  • An HC3 certificate if you are eligible for limited help with health costs. This will show you how much you will need to pay yourself for your health costs.

If you do not believe that you received the help you are entitled to, you may ask for a review. You will need to include the following, your:

  • Full name;
  • Date of birth;
  • Address and postcode;
  • Telephone number;
  • Certificate number;
  • In your own words, why you believe your assessment was incorrect.

Robin is a writer for Your Benefits, writing about aids that people may be entitled to. He is currently working on his Master in journalism at the Institut Supérieur de Formation au Journalisme in Lille.


Ask our experts a question


Your questions
  • Parsons Brian

    I have to travel to Exeter Hospital tomorrow do not drive but age concerns take me to the appointment their charge £30 will the hospital pay me

    • Robin

      Hello,

      You could get paid back through the NHS Low Income Scheme.

      Hope this helps,
      Robin

  • Knowles Paul

    Hi there,
    I actually really don’t have a clue what to do here!
    I have completed an on line form which when completed noted that I was indeed eligible for help with health costs and that all I need to do is to show my latest Universal Credit statement as proof.

    However, I need to claim for travel costs to the many hospital appointments I have had and continue to be scheduled for as below examples:
    Bus fares to and from St Helens Hospital 29th May & 31st May Total = £9.20
    (also historical appointments)??
    Diesel costs for Monday 6th June: my dad is driving me to and from Aintree Hospital and he is a pensioner: can I claim upfront or do I have to do this retrospectively with receipts.
    So my question is do I need to fill any other forms in to claim for travel expenses???
    Many Thanks
    Paul

    • Robin

      Hello Mr. Knowles,
      I believe that you need to ask for a refund if you are not yet fully claiming help with health costs. You can do this online, or through an HC1 form: https://www.nhsbsa.nhs.uk/sites/default/files/2019-11/HC1%20December%202019.pdf

      If you already applied online, you do not need this form.
      I would recommend showing your proof of receiving Universal Credit, and then asking for a refund on your travels. If you have questions because you are not being refunded, I would recommend contacting the NHS.

      Hope this helps,
      Robin

  • BROWN BARBARA

    Hi i am on esa benefit could i be entitled to free dentists etc thank you

    • Robin

      Hello Ms. Brown,

      Yes! If you are on ESA because you are on a low income, then you automatically qualify. You do not even have to apply.

      Hope this helps,
      Robin

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