Low Income Scheme - what you need to know

Anyone can apply as long as they don’t have savings or investments over the capital limit.

If you are resident in England the capital limit is:

£23,250 for those permanently in a care home
£16,000 for everyone else.

If you are resident in Scotland the capital limit is:

£23,250 for those permanently in a care home
£16,000 for everyone else.

If you are resident in Wales the capital limit is:

£24,000 for those permanently in a care home
£16,000 for everyone else

Any help you are entitled to is extended to your partner, if you have one. 

How claims are worked out

Help is based on a comparison between your weekly income and assessed requirements at the time the claim is made (or the date the charge was paid if a refund is claimed). 

Entitlement broadly follows Income Support rules to decide how much, if anything, you have to pay towards your health costs.  The scheme also allows us to include your council tax and housing costs in the assessment.  This means you can get help with your health costs even if your income is too high for Income Support.

What happens after you claim

You will qualify for a full help with health costs HC2 certificate (which includes free NHS prescriptions), if your income is less than or equal to your requirements, or your income is greater than your requirements by no more than half the current English prescription charge.

You will qualify for a limited help with health costs HC3 certificate if your income is greater than your requirements by more than half the current English prescription charge. The HC3 certificate which shows how much you have to pay towards your health costs,

Certificates are usually valid for periods of between six months to five years, depending on your circumstances.

If you have a query

If you have a query about your certificate, call our Customer Contact Team on 0300 330 1343.  We will answer your query straight away if we can, or arrange for a call back at a time that suits you.

Alternatively, complete our Low Income Scheme enquiry form (see related links).

Formal reviews

If you are unhappy with the outcome of your claim, you can ask for it to be formally checked by a Service Improvement Advisor.  Our Service Improvement Team checks whether claims have been correctly assessed in accordance with the regulations governing the scheme.  If the decision was wrong, a new certificate will be sent to you.

To request a review online use the appropriate related link or write to:

Service Improvement Team
Help with Health Costs
Bridge House
152 Pilgrim Street
Newcastle Upon Tyne
NE1 6SN