For Families and Carers : Prescription Charges & the NHS Low Income Scheme

Prescription Charges & the NHS Low Income Scheme (LIS)

Recently there have been a number of calls from parents who had been issued with a fine because they have been told they are not exempt from healthcare charges such as

  • prescription costs
  • dental costs
  • eye care costs

Obviously there is confusion as their child is on benefits and they assumed they would be exempt from charges.

You are not automatically exempt because you get DLA or PIP or you are receiving contribution based ESA.

The only exemptions are for those who get:

  • Income Support
  • income-based Jobseeker’s Allowance
  • income-related Employment and Support Allowance
  • Pension Credit Guarantee Credit

You can apply for the scheme as long as your savings, investments or property (not counting the place where you live) don’t exceed the capital limit. In England, the limit is:

  • £23,250 for people who live permanently in a care home
  • £16,000 for everyone else

Many of our members are in receipt of Contribution based Employment and Support Allowance with no income based part. This is usually because they have moved over from Incapacity benefit (which is also contribution based), or they declined to tell DWP about their child’s savings when they applied for ESA (it is only your child’s savings that they need to know about, but see ‘for those who have savings’ below).

You can ask to be put on to the Income based ESA by asking for an ESA 3 which is a means test form. The Income based ESA has extra premiums in it and in many cases our members are financially better off on this. However please see below:

For those who have savings

If your child has savings of over £16,000, contribution based benefit is fine to stay on because it will be continued to be paid regardless of savings, however you will not qualify for help with prescription charges.

If you asked to be moved from Contribution based ESA onto Income based ESA and you had savings over £16,000 you would not be eligible because of the capital limits and ESA would be stopped.

If your child has savings between £6,000 and £16,000, then for every £250 over the £6,000 they will reduce the Income related benefit by £1. So if your child was on ESA- income based and had savings of £8,000 then they would lose £8 per week benefit.

Applying for help

If you have savings between £6,000 and £16,000 then you can fill out an HC1 form.

You can order an HC1 form online or pick one up at your local Jobcentre Plus office and most NHS hospitals. Your doctor, dentist or optician may also be able to give you one.

If you need help making your claim or you have questions about the LIS, call 0300 330 1343 to speak to an adviser. They can also fill in the form for you and post it to you to sign. All you need to do then is post it back in the envelope provided.

Depending on your circumstances, you can receive “full help” (HC2 certificate) or “partial help” (HC3 certificate). You will qualify for full help if your income is less than or equal to your requirements, or is greater than your requirements by no more than half the current English prescription charge. If your income exceeds this limit, you may be entitled to partial help. Your certificate will show how much you have to pay towards your health costs.

For more help & information call us on 0333 1212 300