TL;DR
The NHS Low Income Scheme (LIS) provides help with NHS health costs including prescriptions, dental treatment, eye tests and hospital travel for people whose income and savings fall below set thresholds. Apply using form HC1. An HC2 certificate gives full help; HC3 gives partial help. Those on Universal Credit, Income Support or Pension Credit Guarantee Credit qualify automatically without needing to apply.
Last reviewed: June 2026
NHS treatment in England is free at the point of use, but certain items carry a charge: NHS prescriptions, NHS dental treatment, NHS sight tests and glasses, and necessary travel to receive NHS treatment. For people on low incomes, these charges can be a genuine barrier to accessing care.
The NHS Low Income Scheme, administered by the NHS Business Services Authority (NHSBSA), provides full or partial help with these costs for people whose income and savings fall below the scheme thresholds. It is separate from the automatic exemptions that apply to certain groups (children under 16, people aged 60 and over for prescriptions, pregnant women, people with certain medical conditions and so on).
KEY FACTS
- NHS prescription charge in England: 9.90 pounds per item in 2026/27.
- HC2 certificate: full help with NHS prescription, dental, sight test, glasses and hospital travel costs.
- HC3 certificate: partial help based on assessed level of contribution you can afford.
- Automatic qualification (no HC1 needed): Universal Credit, Income Support, Pension Credit Guarantee Credit, income-based JSA, income-related ESA.
- Apply at nhsbsa.nhs.uk/help-nhs-costs or request HC1 form from a pharmacy, dentist or GP surgery.
- HC2 and HC3 certificates are valid for up to 12 months; renewal applications must be submitted before expiry.
Who qualifies automatically without applying
Several groups are automatically entitled to help with NHS costs and do not need to apply for an HC2 certificate. If you receive any of the following, you are entitled to free NHS prescriptions, free NHS dental treatment and free NHS sight tests without completing form HC1:
Universal Credit (if your earnings are below 435 pounds per month, or 935 pounds per month if you have a child or limited capability for work). Income Support. Pension Credit Guarantee Credit (note: Savings Credit alone does not qualify). Income-based Jobseeker's Allowance. Income-related Employment and Support Allowance. War Pension Scheme.
Children under 16 are exempt from NHS dental and sight test charges. Young people aged 16 to 18 in full-time education are also exempt. All NHS patients in England are exempt from prescription charges if they are aged 60 or over, have certain medical conditions (including diabetes, epilepsy, cancer and several others), have a maternity exemption certificate, hold a prepayment certificate, or are an NHS inpatient.
Applying for an HC2 or HC3 certificate
If you do not qualify automatically but believe your income and savings may entitle you to help, you need to complete form HC1. The form is available to download from nhsbsa.nhs.uk/help-nhs-costs, or to collect from any GP surgery, pharmacy, NHS dental practice or Jobcentre Plus office. It can also be completed and submitted online.
The HC1 form asks for details of your income from all sources (employment, self-employment, benefits, pensions, savings interest), your savings and capital, and your regular outgoings. The NHSBSA uses this information to calculate whether your income and capital fall below the threshold for full help (HC2) or partial help (HC3).
The assessment takes into account your income, your partner's income if you have one, and any savings or capital above a lower threshold (around 6,000 pounds for most applicants under state pension age, 10,000 pounds for those of pension age). Capital includes savings accounts, ISAs, premium bonds, property you own but do not live in, and some investments.
Processing time is typically around 10 working days after submission. The certificate is sent by post. If you need dental treatment or a sight test urgently before the certificate arrives, your dentist or optician may be able to accept a completed HC1 form as evidence of your application in progress, though practices vary on this.
What an HC2 certificate covers
An HC2 certificate provides full help with the following NHS costs in England. NHS prescriptions: free regardless of the number of items. This includes all medicines and appliances available on NHS prescription. NHS dental treatment: free for all NHS bands of treatment, from a routine examination (Band 1) to complex treatment (Band 3). NHS sight tests: free sight tests at any registered optician. NHS glasses or contact lenses: help toward the cost of glasses or contact lenses, up to the value of the optical voucher amount. The voucher value depends on the lens type required. Hospital travel costs: reimbursement of the cost of travel to and from NHS treatment appointments at the rate of the cheapest appropriate mode of transport.
The HC2 certificate applies across England. If you receive NHS treatment in Scotland, Wales or Northern Ireland, different rules apply under those devolved administrations. Prescription charges, for example, are abolished in Wales, Scotland and Northern Ireland, so the HC2 certificate is less relevant for those visiting those regions for treatment.
What an HC3 certificate covers
If the HC1 assessment finds that you can afford to contribute toward NHS costs but cannot pay the full amount, you will receive an HC3 certificate instead of HC2. The HC3 certificate sets out a maximum contribution, which is the amount you are assessed as being able to pay toward any single item of treatment.
For example, if your HC3 maximum contribution is 3 pounds, you would pay 3 pounds toward an NHS prescription item (rather than the full 9.90 pound charge), 3 pounds toward a Band 1 dental treatment (rather than the full 26.80 pound charge), and so on. The contribution amount is individual and based on your financial circumstances.
NHS prescription prepayment certificates
For people who do not qualify for the Low Income Scheme but pay for more than one NHS prescription per month, an NHS prescription prepayment certificate (PPC) can save money. A PPC costs 111.60 pounds for 12 months (2026/27) and covers an unlimited number of prescription items. At 9.90 pounds per item, the PPC breaks even at 12 items per year and saves money for anyone who pays for more than that.
PPCs are available at nhsbsa.nhs.uk/ppc and can be spread over 10 monthly Direct Debit instalments. They are not income-assessed and are available to all patients in England who are not otherwise exempt from charges.
Reclaiming NHS costs already paid
If you paid for NHS treatment and later receive an HC2 or HC3 certificate that was valid at the time of payment, you may be able to reclaim the charges paid. Claims must be made within three months of the treatment using form HC5, available from the NHSBSA. Keep receipts for any NHS charges paid, particularly dental treatment, as these are required for a successful reclaim.
Frequently asked questions
Who qualifies for the NHS Low Income Scheme?
Anyone whose income and capital fall below the NHSBSA's assessment thresholds can qualify. Those on Universal Credit, Income Support, Pension Credit Guarantee Credit or income-based JSA/ESA qualify automatically. Others should complete form HC1 at nhsbsa.nhs.uk.
What does an HC2 certificate cover?
An HC2 certificate provides full help with NHS prescription charges, NHS dental treatment charges, NHS sight test fees, NHS optical vouchers toward glasses or contact lenses, and hospital travel costs for NHS appointments. It is valid for up to 12 months.
How long does it take to get an HC2 certificate?
Processing takes approximately 10 working days after the NHSBSA receives your completed HC1 form. If you need urgent dental or sight care, speak to your provider about whether they will accept evidence of an application in progress.
Can I claim back NHS charges I have already paid?
Yes, if you paid for NHS treatment within the validity period of an HC2 or HC3 certificate, or if you applied and were awarded one retrospectively. Use form HC5, available from the NHSBSA, and submit within three months of the treatment. Keep all receipts.
