Hc11 Form – Fill Out and Use This PDF

Introduction

This booklet gives guidance about NHS charging arrangements in England only.

The National Health Service (NHS) is, primarily, for the benefit of people resident in the United Kingdom (UK). If a person is accepted for NHS treatment, eligibility for exemption from charges for NHS treatment is based on the conditions described in this booklet.

Most NHS treatment is free, although there can be charges for some things. This booklet sets out information about who does not have to pay charges and also tells you about the help you might get with the cost of the following if you are on a low income:

¥NHS prescriptions

¥NHS dental treatment

¥NHS Sight tests

¥Glasses and contact lenses

¥Necessary costs of travel to receive NHS treatment under the care of a consultant

¥NHS wigs and fabric supports (whenever we say Ôfabric supportsÕ we mean spinal or abdominal supports or surgical brassieres supplied through a hospital).

HOW TO USE THIS BOOKLET

You can quickly check if you are entitled to free treatment by going to the Quick check guides which start on page 8.

For more detailed guidance you need to go to the Contents list starting on page 5 and find the group you most easily fit into, then go to the page number shown (for example, if you are 60 or over, go to page 16).

After reading about the group that most applies to you, check to see if any others also apply (you may fit into more than one group).

For instance, you might be:

¥60 or over and also have a low income

¥pregnant and also have a low income.

If this applies to you, you need to make sure you read about both groups.

When you have found the group, or groups, you belong to and what help you can get, go on to page 41. This tells you how to get help with NHS costs when you go for treatment.

REFUNDS There is also information about refunds in this booklet Ð read pages 48-54.

PENALTY CHARGES If you are found to have made a wrongful claim for help with health costs, you will face penalty charges and may be prosecuted under powers introduced by the Health Act 1999 Ð read page 47.

CURRENT RATES The current rates of NHS charges and optical voucher values in England are listed in the separate leaflet HC12.

Go to page 76 to find out how to get this leaflet.

THIS LEAFLET GIVES GENERAL GUIDANCE ONLY AND SHOULD NOT BE TREATED AS A COMPLETE AND AUTHORITATIVE STATEMENT OF LAW.

Contents

QUICK CHECK GUIDES
NHS prescriptions	8
NHS dental treatment	9
NHS sight tests	10
NHS optical vouchers	12
NHS travel costs	13
NHS wigs and fabric supports	14
AGE GROUPS
Children under 16	15
Young people aged 16, 17
and 18 in full-time education	15
Other young people not
in full time education	16
People 60 or over	16

INCOME GROUPS

People getting benefits or tax credits 17

Income Support	17
JobseekerÕs Allowance	17
Pension Credit Guarantee Credit	18
Other benefits	19
Tax credits	20
People with a low income	23
OTHER GROUPS
War pensioners	28
People from abroad	28
People with specified medical
conditions	30

Pregnant women and those who have

had a baby in the previous
12 months	32

People who need lots of prescriptions 33

People registered severely
sight-impaired/blind or
sight-impaired/partially sighted	34
People who need complex lenses	34
People who have lost or damaged
their glasses or contact lenses	35
People with impaired hearing	35
People living in a care home	36
People supported by a local
authority after leaving care	36
NHS in-patients	37
NHS out-patients/day patients	37
People who need to travel
for NHS treatment	38
NHS treatment abroad	40
Isles of Scilly	40
CLAIMING HELP WHEN YOU
GO FOR TREATMENT
NHS prescriptions	41
NHS dental treatment	42
Sight tests	43
NHS vouchers for glasses or contact
lenses	44

NHS vouchers for repair or replacement

of glasses or contact lenses	45
Travel to receive NHS treatment
under the care of a consultant	45
NHS wigs and fabric supports	45

CHECKS OF ENTITLEMENT
Checking your entitlement	46
PENALTY CHARGE	47
CLAIMING REFUNDS
NHS prescription charges	48
Prescription prepayment
certificate fees	48
Other refunds	50
NHS dental charges	51
Sight test fees	52
Glasses or contact lens costs	52
Travel costs to receive NHS
treatment	53
NHS wig and fabric support charges	53
War pensioners	54
PROOF OF ENTITLEMENT TABLES
NHS prescriptions	56
NHS dental treatment	62
NHS sight tests	68
NHS sight tests and optical vouchers	72
ORDERING FORMS AND LEAFLETS	76
ADVICE LINES	78

Quick check guides

NHS PRESCRIPTIONS

You can get free NHS prescriptions if at the time the prescription is dispensed you:

¥are aged 60 or over

¥are under 16

¥are aged 16, 17 or 18 in full-time education

¥are pregnant, or have had a baby in the previous 12 months and have a valid exemption certificate

¥have a listed medical condition and have a valid exemption certificate

¥have a continuing physical disability which means you cannot go out without help from another person and have a valid exemption certificate

¥are an NHS in-patient

¥are getting, or your partner gets:

ÐIncome Support

ÐIncome-based JobseekerÕs Allowance (Incapacity Benefit or Disability Living Allowance do not count, as they are not income- related)

ÐPension Credit Guarantee Credit

¥are entitled to, or named on, a valid NHS tax credit exemption certificate

¥are named on a valid HC2 certificate

¥are a war pensioner, the prescription is for your accepted disablement and you have a valid war pension exemption certificate.

Supplied free:

¥medication administered at a hospital or an NHS Walk in Centre

¥prescribed contraceptives

¥medication personally administered by a GP

¥medication supplied at a hospital or PCT clinic for the treatment of a sexually transmissible infection (STI).

NHS DENTAL TREATMENT

You can get free NHS dental treatment if:

•when the treatment starts you are:

¥aged under 18

¥aged 18 in full-time education

¥pregnant, or have had a baby

in the 12 months before treatment starts

¥an NHS in-patient and the treatment is carried out by the hospital dentist

¥an NHS Hospital Dental Service out-patient*

¥a Community Dental Service patient.*

*There may be a charge for dentures and bridges.

•when the treatment starts or when the charge is made:

¥you are getting, or your partner gets:

ÐIncome Support

ÐIncome-based JobseekerÕs Allowance (Incapacity Benefit or Disability Living Allowance do not count as they are not income-related)

ÐPension Credit Guarantee Credit ¥ you are entitled to, or named on, a

valid NHS tax credit exemption certificate

¥ you are named on a valid HC2 certificate.

Partial help: if you are named on a valid HC3 certificate you might get some help towards the cost of your NHS dental treatment.

War pensioners Ð read page 28.

NHS SIGHT TESTS

You can get free sights tests if you:

¥are under 16

¥are aged 16,17 or 18 in full-time education

¥are aged 60 or over

¥are a diagnosed glaucoma patient

¥have been advised by an ophthalmologist that you are at risk of glaucoma

¥are aged 40 or over and are a parent, brother, sister, son or daughter of a diagnosed glaucoma patient

¥have been diagnosed as diabetic

¥are registered as severely sight- impaired/blind or sight-impaired/ partially sighted

¥need complex lenses

¥are someone whose sight test is carried out through the hospital eye department as part of the management of your eye condition

¥are getting, or your partner gets:

ÐIncome Support

ÐIncome-based JobseekerÕs Allowance (Incapacity Benefit or Disability Living Allowance do not count as they are not income- related)

ÐPension Credit Guarantee Credit

¥are entitled to, or named on, a valid NHS tax credit exemption certificate

¥are named on a valid HC2 certificate.

Partial help: if you are named on a valid HC3 certificate you might get some help towards the cost of a private sight test.

War pensioners Ð read page 28.

NHS OPTICAL VOUCHERS

You can get vouchers towards the costs of glasses or contact lenses if you:

¥are under 16

¥are aged 16, 17 or 18 in full-time education

¥need complex lenses Ð read page 34

¥are getting, or your partner gets:

ÐIncome Support

ÐIncome-based JobseekerÕs Allowance (Incapacity Benefit or Disability Living Allowance do not count as they are not income- related)

ÐPension Credit Guarantee Credit

¥are entitled to, or named on, a valid NHS tax credit exemption certificate

¥are named on a valid HC2 certificate.

Partial help: if you are named on a valid HC3 certificate, you might get some help.

NOTE: If your glasses or contact lenses cost more than your voucher value, you will have to pay the difference.

War pensioners Ð read page 28.

NHS VOUCHERS FOR REPAIR OR REPLACEMENT OF GLASSES OR CONTACT LENSES

You can get vouchers if you:

¥are under 16 (if you are 16 or over, conditions apply Ð read page 35).

NHS TRAVEL COSTS

You can get help with necessary cost of travel to receive NHS treatment under the care of a consultant if you:

¥are getting, or your partner gets:

ÐIncome Support

ÐIncome-based JobseekerÕs Allowance (Incapacity Benefit or Disability Living Allowance do not count as they are not income- related)

ÐPension Credit Guarantee Credit

¥are entitled to, or named on, a valid NHS tax credit exemption certificate

¥are named on a valid HC2 certificate (includes travel by your dependent children)

¥are a war pensioner and the treatment is for your accepted disablement

Children under 16 and young people 16 and over Ð read pages 38-39.

Partial help: if you are named on a valid HC3 certificate you might get some help.

NHS WIGS AND FABRIC SUPPORTS

You can get free wigs and fabric supports if you:

¥are under 16

¥are aged 16, 17 or 18 in full-time education

¥are a hospital in-patient

¥are a war pensioner and the wig or fabric support is for your accepted disablement and you have a valid war pension exemption certificate

¥are getting or your partner gets:

ÐIncome Support

ÐIncome-based JobseekerÕs Allowance (Incapacity Benefit or Disability Living Allowance do not count as they are not income- related.)

ÐPension Credit Guarantee Credit

¥are entitled to, or named on, a valid NHS tax credit exemption certificate

¥are named on a valid HC2 certificate.

Partial help: if you are named on a valid HC3 certificate you might get some help.

Age groups

CHILDREN UNDER 16 AND YOUNG PEOPLE AGED 16, 17 AND 18 IN FULL-TIME EDUCATION

Full-time education means you must be receiving full-time instruction from a recognised educational establishment, such as a school, college or university. To be a Ôrecognised establishmentÕ the place where you are studying must have a Department of Education and Skills (DfES) Establishment Number, and be registered on the DfES database. If it is not registered with the DfES, you still may be able to claim for help with health costs under the NHS Low Income Scheme Ð read pages 23-27.

You are not considered to be receiving full-time education once you have finished your A Levels (or equivalent) as you will have come off a school or college register and have not actually started at college/university.

You get free:

¥NHS prescriptions

¥NHS dental treatment for any course of treatment that starts before your 19th birthday

¥NHS sight tests

¥NHS wigs and fabric supports.

You also get:

¥vouchers towards the cost of glasses or contact lenses

¥if you have lost or damaged your glasses or contact lenses Ð

read page 35

¥if you need help with travel costs to and from hospital for NHS treatment Ð read pages 38-39.

OTHER YOUNG PEOPLE NOT

IN FULL-TIME EDUCATION

You get free:

¥NHS dental treatment for any course of treatment which starts before your 18th birthday

You also get help:

¥with travel costs to and from the hospital for NHS treatment Ð read pages 38-39

¥if you are aged 16 or 17 and are supported by a Local Authority because you have recently left Local Authority care Ð read page 36

¥if you do not have much money to pay other health costs, you can still claim for help Ð read pages 23-27.

PEOPLE AGED 60 OR OVER

You get free:

¥NHS prescriptions

¥NHS sight tests.

If you need help with other health costs, check to see if you fit into any of the groups listed on pages 5Ð7.

Income groups

PEOPLE GETTING BENEFITS OR TAX CREDITS

Either you or your partner may be getting the benefit or credit.

If you are waiting for your claim to be settled and need help urgently with any health costs Ð read pages 23-27.

INCOME SUPPORT (IS)

You and your partner get free:

¥NHS prescriptions

¥NHS dental treatment

¥NHS sight tests

¥NHS wigs and fabric supports.

You also get:

¥a voucher towards the cost of glasses or contact lenses

¥refunds of necessary travel costs to receive NHS treatment under the care of a consultant for you, your partner and any dependent children and young people under 19.

INCOME-BASED JOB SEEKER’S

ALLOWANCE – JSA (IB)

You and your partner are entitled to the same things as people getting Income Support Ð see above.