| The NHS Low Income
Scheme
The Authority's Patient Services
administers the NHS Low Income Scheme (LIS) on behalf
of the Department of Health for England, the Scottish
Executive Health Department and the National Assembly
for Wales. The Scheme provides income related help with
health costs for people who are not exempt, nor automatically
entitled to remission from NHS chargeable services,
but who may nevertheless be entitled to help with the
following costs on low income grounds:
- NHS prescriptions
- NHS dental treatment
- Sight tests, glasses and contact
lenses
- Travel to hospital for NHS treatment
- NHS wigs and fabric supports
The LIS Claims Process
LIS claims are made using form HC1.
[to
request a form click here].
The extent of any help available is
based on a comparison between a person's weekly income
and their assessed requirements
at the time the claim is made (or the date the charge
was paid if a refund is claimed). Any help a person
is entitled to is extended to their partner and dependent
children, if applicable. Anyone can make a claim, providing
they do not have capital which exceeds the capital limit.
The capital limits are as follows:
If
you are resident in England or Scotland:
-
£22,250 for those permanently in a care home
-
£16,000 for everyone else
If
you are resident in Wales:
-
£22,000 for those permanently in a care home
-
£16,000 for everyone else
LIS assessments are broadly based on
Income Support arrangements to determine how much, if
anything, a person should contribute towards their health
costs. However, the Scheme also allows for the inclusion
of council tax and housing costs in the assessment.
People
are entitled to full help with NHS charges (which includes
free NHS prescriptions), and are sent an HC2 certificate,
if their income is less than or equal to their requirements
or their income is greater than their requirements by
no more than half the current English prescription charge.
People are entitled to limited help with certain NHS
charges, and are sent an HC3 certificate which shows
how much they are expected to contribute to their health
costs, if their income is greater than their requirements
by more than half the current English prescription charge.
Certificates are usually valid for periods of between
6 months to 5 years, depending on a person's circumstances.
The Scheme is designed so that people can claim help
in advance of incurring a cost and are able to budget
accordingly. However, if charges have already been incurred,
refund claims and claims for certificates may be made
at the same time.
Customers who wish to query the outcome
of their claims are entitled to ask for their claim
to be formally reviewed. The Review Section considers
whether claims have been assessed in accordance with
the provisions of the regulations governing the Scheme
(The NHS (Travelling Expenses and Remission of Charges)
Regulations, 2003, as amended).
To request a review click on "Go
To Form" or write to:
Review Section
NHS Business Services Authority
PO Box 993
NEWCASTLE UPON TYNE
NE99 2TZ
You will normally hear from the Review Section within
four weeks.
If you have any general queries about
your claim, how to fill in the form or what to send
us, you can call us on 0845 850 1166. Or, complete our
query
form.
A full list of the ways in which people
may obtain help with health costs is available. If you
are resident in:
For details of current charges and optical voucher values in:
Refunds
To
claim a refund of NHS charges, except prescription charges,
you need to complete form HC5 appropriate to the charge you paid. The HC5 tells you what
to do. To request an HC5 form click here.
If you need to pay for your treatment
prior to applying under the Low Income Scheme or seeking
other exemption you may be able to claim a refund. If
you are resident in:
Frequently Asked Questions (FAQ's)
Generic
FAQ's
General
Assessment FAQ's
Student
Specific FAQ's
Retirement
Pension / Benefit Specific FAQ's
Earnings
Specific FAQ's
Refunds
Specific FAQ's
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