You can get the main hc1 claim form by phoning 0300 123 0849. The nhs business services authority will share the information that you give with our supplier who then post the forms to you. Hc1 claim for help with health costs nhs business services. Hc1 claim for help with health costs d a te t i me o f f i c i a l u s e b ox p h o ne 1 p h o n e 2 d a te t i me part 1 about you and your partner no yes mr,mrs,miss,ms,other first name. Wales, you can get a hc1 form by calling 0845 6031108 select the option for health publications. It can be used to share information with the doctors responsible officer in the following situations. If youre funded by student finance england or student finance wales, the student finance breakdown we need as evidence may look like this. However, much or all of the cost can, in some cases be reclaimed, waived or you may be eligible for help under the nhs low income scheme. Local nhs england teams are responsible for establishing local registration authorities ras to manage the issuing of smartcards to access the electronic prescription service eps.
To order forms hc1 and hc1 sc or request hc1 in large print or other formats or for help to complete a form, call help with health costs helpline. This leaflet tells you about your free nhs eye examination. If english is not your first language, phone this number and we will. Use this form to claim back the cost of nhs dental treatment. You cannot get help with health costs if you or your partner or both have more than. Details please read the notes on the form before filling it in they will help you make your claim correctly.
For the nhs low income scheme, the amount of help you get depends on the. Please ensure you send all the pages of the completed form to us when you make your claim. If youre unable to print one off, you can order an hc1 hc5 to be sent out to you, this will take 5 working days to arrive. You can also get an hc1 form by calling 0300 123 0849. You may be entitled to help through the nhs low income scheme use this form if you need help with paying for. Queries about prescription prepayment certificates ppcs 0300 330 41. Hc1 form is there support for students for prescription costs. If you have a question about a government service or policy, you should contact the relevant government organisation directly as we dont have access to information about you held by government departments. When you get the hc1 form, there will be a prepaid envelope provided somewhere inside the form. To apply for either a full help certificate or a limited help certificate through the low income scheme, fill in form hc1, which is available from local benefit offices, nhs hospitals, dentists, opticians and pharmacists. The advanced tools of the editor will guide you through the editable pdf template. The first sector is the detailed introduction of the hc1 that insturcts you how to use the form. All referrals and any communication containing patient identifiable information must be made using a secure nhsmail account only.
In england, depending on your income, you can get prescriptions free of charge if you. Use this stepbystep instruction to complete the hc1 form nhs quickly and with perfect accuracy. Queries about medical exemption certificates 0300 330 41. Use form hc1 to claim for help with paying for health and travel costs for you, your partner or your children. This form should only be used if the dental practice was in england. England click here to download and print off an hc1. Hc1 and hc1 sc or request hc1 in large print or other formats or for help to complete. Oct 05, 2009 thanks for that, just before i send it off does anyone know if that address is for everyone in england, i am from stoke on trent if that helps yes, its for everyone.
Noteif you live permanently in a care home and you have a partner and they need help with their health costs, they should use their own claim form hc1sc or an hc1, whichever is appropriate. In england, there are a number of ways to buy a prepayment certificate which may make. It is also helpful while asking for the cost help for prison visits and expenses connected with this. If you are a uk resident who is living abroad parttime or visiting scotland, the rules are more complicated. Nhs business services authority bridge house 152 pilgrim street newcastleupontyne ne1 6sn tel. You may also have to fill in an hc1 claim form for the nhs low income scheme see part 4. Jan 17, 2008 im on incapacity benifet and i live with my partner who works and earns about. The portal functionality remains unchanged and you should have access to the same catalogues and ordering organisations as before. You will need to ask an opticians practice whether you. If you apply to the nhs low income scheme and receive an hc2 certificate for full help with health costs, youre entitled to. Nhs low income scheme nhs business services authority bridge house 152 pilgrim street newcastle upon tyne ne1 6sn you will need to use a stamp. Hm land registry use only record of fees paid any parts of. We may contact you to discuss your application and our quality of service to you.
You do not have to wait until you need treatment before you apply for a certificate. You may be entitled to help through the nhs low income scheme. Hc2 certificates full help with health costs nhsbsa. I did so and was swiftly awarded a hc2 certificate, that entitled me to free treatments. Eptica self service where can i get a hc1 hc5 form from. Welcome to the refreshed nhs forms, print, exemptions, cards and ehic contract online ordering portal provided by xerox. I am a full time student in my final year at university. If you need more room than is provided for in a panel, and your software allows, you can expand any panel in the form. To request access to your own health records or those of a deceased person, the most efficient way to submit the request is to complete the application form which can be downloaded here.
If you live in a shared house and you have your own tenancy agreement, you do not need to tell us about the other people living with you in that house. Nhs england medical practice information transfer mpit form. If you already have an hc2 or hc3 certificate through the nhs low income scheme and would like to renew it, you will still need to complete a new hc1 form. If you meet the criteria for a hc1sc, you can order one from xerox uk. Filling in a hc1 form for dental treatment should healthcare be free for fulltime students. Help with health costs in scotland health rights nhs. We will retain your address information for no more than a year to monitor trends in how customers order the application form and the number of completed forms we receive. Hc1 applications this dashboard shows information about how the nhs low income scheme.
Hc1 form is a document to claim for help with health and travel costs. Accessing medical records primary care support england. Help with health costs by calling 0345 603 1108 or visiting. If you have paid an nhs dental charge you must receive a receipt, either an nhs receipt form. Hc1 form fill out and sign printable pdf template signnow. Hc1 claim for help with health costs do you find it difficult to pay for health costs you may be entitled to help through the nhs low income scheme use this form if you need help with paying for nhs prescriptions nhs dental treatment nhs wigs and fabric supports sight tests glasses and contact lenses or travel to receive nhs treatment under the. Phone our customer enquiry line on 0845 850 1166and we will tell you what to do. If you live in scotland click here to download and print off an hc1. Form hc1 can also be printed from the nhs business services authority website at. You only need to tell us about people who live with you in your home. Complete this form if you are on a low income, or need help with healthcare costs. A range of downloadable referral forms and related guidance documents are available below for practices, covering areas of dental specialty and location specific requirements. We may pass this information to other agencies, nhs or other organisations such as hospitals, nhs england, department for work and pensions and hm revenue and customs to prevent and detect crime. You can use it to report a problem or suggest an improvement to a webpage.
Claim for help with health and travel costs form hc1 nidirect. How do i claim a refund of nhs wigs and fabric support charges paid in england. You can order an hc1 form online or download it pdf, 451kb. The helpline can provide an interpreter if english is not your first language. Help with health costs in scotland health rights nhs inform. Print and fill in the form and return it to the practice you want to register with. England you can download and print off an hc1 hc5 from our website.
Where can i get an hc1 application form or hc5 refund claim form. Download and create your own document with hc1 claim form 32kb 4 pages for free. Sep 25, 20 if youre completing an hc1 form and in fulltime education, you must include a copy of the financial assessment you receive from your funding agency. Im a full time university student, in second year, living with my parents and having some issues filling in the hc1 form part 1 says about you and your partner, part 5 says about your income, part 6 says about work and part 8 says people in full time education this asks questions such as are you in the final year of your course, do you or your partner live with parents during term. Jul 30, 20 in part 3 of the form we ask about other people who live with you. If youre not on a qualifying benefit s but you still have difficulty paying nhs charges, you may qualify for help under the nhs low income scheme. If you are a uk resident, you can get a free nhs eye examination in scotland. How you obtain hc1 hc5 forms depends on which uk country youre in and. The medical practice information transfer mpit form is designed to support the appropriate transfer of information about a doctors practice to and from the doctors responsible officer.
If you have a low income, the nhs low income scheme could help you pay for. No recourse to public funds free prescriptions and other nhs. Where can i get an hc1 application form or hc5 refund claim. Hc1 form fill online, printable, fillable, blank pdffiller. They can be downloaded, completed online, printed and signed in wet ink. This feedback form is for issues with the nidirect website only. Alternatively, you can click here to order one to be sent out to you, this will take 5 working days to arrive. The new mandatory form can be obtained online from the nhs prescription services website. The way to complete the online hc1 form on the internet. If you meet the criteria for a hc1 sc, you can order one from xerox uk. Any english prescription form presented for dispensing in scotland will be charged at the english rate, unless the prescription form is accompanied by an entitlement card, confirming the patient is eligible to receive the items free of charge, or the patient qualifies for exemptionremission of charges as listed in regulation 4 of the nhs free. Nhs england is the data controller of gp health records where an individual is not currently registered with a gp or is deceased. Record of fees paid any parts of the form that are not typed should be completed in black ink and in block capitals.
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