Low Income Scheme refunds




To claim a refund of NHS charges, except prescription charges, fill in form HC5.  The form tells you what to do. 

If you need to pay for your treatment before applying to the NHS Low Income Scheme or seeking other exemption you may be able to claim a refund.

Obtaining form HC5

If you are resident in England and want to claim a refund of the cost of:
  •  NHS wigs or fabric supports, you can download form HC5(W).
  • NHS dental treatment, a sight test, glasses, contact lenses or travel costs to receive NHS treatment under the care of a consultant or through a referral by a doctor or dentist, you can place an order for an HC5 form, which will be posted to you.

If you are resident in Scotland you can download and print off a Scottish HC5.  Please ensure you send all pages of the completed form when making your claim.  You can also get a copy of the Scottish HC5 form from your GP surgery or community pharmacy.

If you are resident in Wales you can get a copy of the appropriate Welsh HC5 form by calling 0845 6031108 (select the option for health publications).  You may also be able to get one from a Jobcentre Plus offices, NHS hospitals, doctors surgeries, dentists or opticians.