HC1W - Claim for Help with Health Costs

Use this form if you need any of the following:

• NHS prescriptions
• NHS dental treatment
• NHS wigs and fabric supports
• Sight tests, glasses and contact lenses
• Travel to receive NHS treatment under the care of a consultant

You might not have to pay for them or you could be entitled to some help towards the cost.

You can claim at any time - Don’t wait until you need treatment.

You can claim for: yourself; your partner; your children.

If you need help or have any queries about filling in this form, you can phone our customer enquiry line on 0845 850 1166. If English is not your first language, you can phone this number and tell us in English, or ask a friend to tell us, your preferred language and we will provide a phone interpretation service.

You DON’T need to fill this form in if you or your partner are getting:

• Income Support
• Pension Credit Guarantee Credit
• Income-based Jobseeker’s Allowance; or if
• You are named on, or entitled to, a NHS Tax Credit Exemption Certificate

You are already entitled to full help with health costs - but if you paid any health costs before you started getting any of these benefits or before you became entitled to your NHS Tax Credit Exemption Certificate, read the back cover of this form to find out how to claim your money back.

You CANNOT get help with health costs if you and/or your partner together have more than:

• £8,000 in savings, investments or property (not counting the place where you live)
• £12,000 in savings, investments or property (not counting the place where you live) if you and/or your partner are 60 or over
• £20,000 in savings, investments or property if you live permanently in a care home.