Help with health costs

In Scotland, the majority of NHS services are provided free of charge, including:

• GP practices
• local pharmacies
• hospitals
• clinics
• emergency services
• eye examinations
• dental examinations

Services that you may have to pay for include:

• NHS dental treatments (from aged 26 and above)
• glasses and contact lenses (in most cases)

You’re entitled to certain NHS items and services free of charge if you:

• are under 26 years old
• receive certain benefits
• are on a low income
• are pregnant or have given birth in the last 12 months
• have an entitlement card
• have a medical exemption certificate
• need to travel to hospital for NHS treatment

The Scottish Government also provide further information about health costs and entitlement

Young people

Young people under 26 years old get:

• free NHS dental treatment for any course of treatment that starts before your 26 birthday

Young people in full time education aged 16, 17 and 18 get:

• a voucher towards the cost of glasses or contact lenses
• help with travel costs to and from hospital for NHS treatment

Defining full-time education

Full-time education means you must be receiving full-time instruction at a recognised education establishment or in another setting comparable to a school, college or university (for example, home education).

You are generally not considered to be receiving full-time education once you have come off a school or college register, or have finished receiving comparable education.

If you are not entitled to education-based exemption, you may be able to claim for help with health costs under the NHS Low Income Scheme.

Other young people

Young people not in full-time education get:

• free NHS dental treatment for any course of treatment which starts before your 26th birthday
• you could also be entitled to help with travel costs to and from hospital for NHS treatment.

If you’re aged 16 or 17 and supported by a Local Authority because you have recently left Local Authority care you are entitled to full help with health costs through the NHS Low Income Scheme.

If you don’t have much money to pay other health costs, you can still apply for help under the NHS Low Income Scheme.

Receiving benefits

If you’re included in an award of:

• Income support
• Income-related Employment and Support Allowance
• Income-based Jobseeker’s Allowance
• Pension Credit Guarantee Credit, or
• An NHS Tax Credit Exemption Certificate

You’re entitled to:

• free NHS dental treatment
• vouchers towards the cost of glasses or contact lenses
• a refund of any reasonable amount spent on travel to receive treatment at an NHS hospital

Universal credit

If you’re included in an award of Universal Credit:

• and have had no earnings or net earnings (take-home pay) of £435 or less during the most recent assessment period, or
• which includes an element for a child and/or limited capability for work-related activity, and have had no earnings or net earnings (take-home pay) of £935 or less during the most recent assessment period

You’re entitled to:

• free NHS dental treatment
• vouchers towards the cost of glasses or contact lenses
• a refund of any reasonable amount spent on travel to receive treatment at an NHS hospital

To claim your entitlement when you have your treatment, tell the practitioner which benefit you’re in receipt of. The practitioner will then ask you for evidence of your entitlement and ask you to sign a form.

Low income

If you’re 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.

This is an income-related scheme which looks at your (and your partner’s) weekly needs and income to calculate how much, if anything, you should pay towards your health costs. Help with hospital travel costs may also be available.

The threshold for full help under the Scheme changes from time to time, so if you haven’t claimed for a while, it may be worth making a new claim.

If you want to claim help under the Low Income Scheme, pick up form HC1 at:

• community pharmacies
• GP practices
• Citizens Advice Scotland offices
• Jobcentre Plus offices

HC1 application

You can complete the HC1 form if you’re on a low income, or need help with healthcare costs.

You can check if you’re eligible for help with health costs.

Pregnant

If you’re pregnant or have given birth in the last 12 months you get free NHS dental treatment.

To get this, you will need to apply for an NHS Maternity Exemption Certificate. This certificate will also entitle you to free prescriptions if you’re from Scotland and are receiving your prescriptions in England.

Application forms are available from your GP, midwife or health visitor. They will help you to complete the form and will send it to your NHS Board. You will receive your certificate by post.

Entitlement card

What is an entitlement card?

If you live in Scotland but are registered with a GP Practice in England you may apply for an Entitlement Card. This will serve as evidence that you are eligible for free prescriptions in Scotland.

Entitlement Cards will be issued free of charge to eligible applicants. The Entitlement Card must be shown when you are presenting your prescription to benefit from the abolition of prescription charges in Scotland.

The address details on the Entitlement Card must match the address details on the prescription form.

How can I get an entitlement card?

Please contact NHS National Services: Practitioner Services Division on 0141 300 1300 who will send you an application form.

Medical exemption certificate

If you have one of the following medical conditions:

• hypoparathyroidism
• hypoadrenalism for which specific substitution therapy is essential (e.g. Addison’s Disease)
• diabetes insipidus and other forms of hypopituitarism
• diabetes mellitus, except where treatment is by diet alone
• myasthenia gravis
• hypothyroidism requiring thyroid hormone replacement (myxoedema)
• epilepsy requiring continuous anti-convulsive therapy
• a stoma (permanent fistula requiring continuous surgical dressing or requiring an appliance)
• continuing physical disability which means that you are unable to leave your home without the help of another person

You may wish to apply for an NHS Medical Exemption Certificate that will entitle you to receive NHS prescriptions free of charge if presenting your prescription in England.

To apply for a Medical Exemption Certificate, ask the receptionist at your GP surgery.

An application form EC92A will be completed at the surgery, and will be approved by your GP.

The surgery will send off the application to your NHS Board and you will receive your certificate by post.

Travel costs

If you travel to hospital for NHS treatment you may be entitled to help with necessary travel costs . This includes check-ups and visits to clinics for treatment of sexually transmissible infections.

You can get help:

• if you are getting a qualifying benefit(s)
• if you are entitled to help through the NHS Low Income Scheme
• for your companion if you qualify for help and, for medical reasons, you need a companion to travel with you – their travel costs are added to your travel costs and it’s your income that counts
• if you are 16 or over but under 20 and are counted as a dependant of someone getting help (on the basis of a qualifying benefit) or through the NHS Low Income Scheme – otherwise you can make your own claim, even if you live with your parents

If a child under 16 is the patient, it is their parents’ income that counts. If someone else takes them to hospital, it is still the parents’ income that counts. If you are not sure what travel costs you can get help with, ask the hospital before you travel.

Living in the council areas of Highland, Argyll & Bute, Western Isles, Orkney and Shetland

If you live in the mentioned areas you get help with the cost of travel to hospital for NHS treatment, provided you have to travel at least 30 miles (48km), or more than 5 miles (8km) by sea, to get to hospital.

There is a set maximum you have to pay unless you get free travel, or help with the costs. Leaflet HCS2 tells you how much this is.