Form HC1 – Fill, Sign and Download | NHS Help with Health Costs
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Form HC1 is the application form for the NHS Low Income Scheme (LIS) — a UK-wide scheme that helps people on low incomes pay for NHS health costs. Successful applicants receive either an HC2 certificate (full help — all costs covered) or an HC3 certificate (partial help — limited contribution). The certificate is then shown when collecting prescriptions, paying for dental or eye care, or claiming back NHS travel expenses.
The Low Income Scheme can help with: NHS prescription charges in England (currently £9.90 per item); NHS dental treatment costs across the UK; NHS sight tests; vouchers towards the cost of glasses or contact lenses; wigs and fabric supports; necessary travel costs to receive NHS treatment (where referred by a doctor, dentist, or hospital). It does not cover private treatment or services not provided on the NHS, and it does not cover most over-the-counter medicines.
Anyone whose household income is low enough may apply, regardless of employment status. You're typically not eligible (or won't need to apply) if you already receive certain qualifying benefits — Income Support, income-based Jobseeker's Allowance, income-related Employment and Support Allowance, Pension Credit Guarantee Credit, or Universal Credit with earnings under a threshold — because those benefits automatically entitle you to free NHS prescriptions and other help. HC1 is mainly for people on low incomes who don't receive those qualifying benefits. Students with limited income, asylum seekers, prisoners on release, and people in care homes have specific routes within the scheme.
Fill in details on your household, income from all sources, savings, housing costs, and people who depend on you financially. Include supporting documents — payslips, benefit letters, rent or mortgage statements, council tax bill, and bank statements showing savings. Send the completed HC1 by post to the address printed on the form (currently the NHS Business Services Authority in Newcastle). Processing usually takes a few weeks. If approved, you receive an HC2 or HC3 certificate valid for up to 12 months, after which you reapply if your circumstances haven't changed.
1. Vul het formulier in.
Vul uw gegevens en informatie in, voeg datum toe en pas aan zoals nodig
2. Je handtekening toevoegen
Voeg juridisch bindende handtekening toe door te tekenen, uploaden of typen
3. Download of deel
Uw formulier is klaar, download, deel link of verstuur via e-mail direct