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NHS Low Income Scheme: a complete guide to getting help with healthcare costs

Verified against NHSBSA, GOV.UK, GOV.WALES, GOV.SCOT and nidirect on 4 August 2026 · Next review due 1 April 2027

Some NHS care is free everywhere. Some of it is not, and what you pay depends heavily on which UK nation you live in. The NHS Low Income Scheme exists for people whose income is low but who do not automatically qualify for free NHS costs through a benefit. This guide sets out who it is for, exactly what it covers, and the two deadlines that catch most people out.

What is the NHS Low Income Scheme?

The NHS Low Income Scheme (LIS) helps people who have a low income but do not automatically qualify for free NHS healthcare costs through a benefit. Rather than asking only whether you receive a particular benefit, the scheme assesses your income, your savings, your housing costs and your personal circumstances.

If your application succeeds you receive one of two certificates: an HC2 for full help, or an HC3 for partial help. The difference between them matters a great deal, and it is explained in full below.

Which nations run it? The scheme operates in England, Scotland and Wales, and you can apply through the NHS Business Services Authority. Northern Ireland runs its own closely equivalent Help with Health Costs scheme, which also issues HC2 and HC3 certificates but uses its own forms and its own application route. A common error in online guides is to describe the scheme as England-only.

What the scheme covers — and the HC2 versus HC3 trap

This is the most misunderstood part of the scheme, so it is worth being precise. An HC2 and an HC3 do not cover the same things.

Check the automatic exemptions first

Before applying, check whether you are already exempt. If you are, you do not need the Low Income Scheme at all and applying will only waste your time. In England you get free NHS prescriptions if you are:

• Aged under 16, or aged 16 to 18 and in full-time education, or aged 60 or over
• Receiving Income Support, income-based Jobseeker's Allowance, income-related Employment and Support Allowance, or Pension Credit Guarantee Credit
• Receiving Universal Credit and, in your most recent assessment period, you had no earnings or net earnings of £435 or less — or £935 or less if your award includes a child element or an element for limited capability for work
• Holding a valid medical exemption certificate, maternity exemption certificate or war pension exemption certificate
• Named on a valid HC2 certificate
• An NHS inpatient

One trap worth naming: contribution-based benefits do not passport you. New Style Jobseeker's Allowance and New Style Employment and Support Allowance give no automatic exemption. Claimants of those benefits are precisely who the Low Income Scheme is designed for.

Medical exemption certificates now last ten years

If you have one of the qualifying long-term conditions — including diabetes mellitus treated by anything other than diet alone, epilepsy needing continuous anticonvulsive therapy, hypothyroidism needing thyroid hormone replacement, hypoparathyroidism, myasthenia gravis, a form of hypoadrenalism such as Addison's disease, a permanent fistula, or a continuing physical disability that means you cannot go out without help from another person — you can apply for a medical exemption certificate through your GP using form FP92A.

These certificates now run for ten years. Applications received before 16 July 2026 were issued for five. Cancer-related certificates remain five years. Some NHSBSA help articles still say five years across the board; the main certificates page is the current source.

Savings and income: the limits that decide it

You cannot get help under the scheme if your savings, investments or property (not counting the home you live in) exceed:

• £16,000 in most cases
• £23,250 if you live permanently in a care home — £24,000 in Wales

Separately, there is a £6,000 limit on the online application route. If you have more than £6,000 in savings you are still eligible for the scheme, but you must apply on paper rather than online. You also cannot apply online if you live in Northern Ireland, if you are a student with a partner living with you, or if you have no income at all.

Your household income is what is assessed, not your employment status. People who work part-time, are self-employed, are retired, or already receive some benefits can all qualify depending on the figures.

How to apply

Gather your paperwork first. You will need details of your income, your savings, your housing costs, your household circumstances and any benefits you receive.

NHSBSA states it usually assesses an application within 18 working days. Certificates are normally valid for between six months and five years depending on your circumstances; in Northern Ireland they are issued for twelve months. If your circumstances change significantly, you may need to reapply.

Refunds: the deadline almost everyone misses

Healthcare Travel Costs Scheme

Getting to appointments is a real cost, particularly for people on long courses of treatment or travelling to a specialist centre. The Healthcare Travel Costs Scheme can refund public transport fares, car mileage at your integrated care board's rate, parking, tolls and pre-approved taxi fares.

Three conditions must all be met:

1. You receive a qualifying benefit, or hold an HC2 or HC3 certificate — both give access to this scheme
2. You have a referral for specialist care from a healthcare professional to a specialist or a hospital
3. The appointment is on a separate visit from the one at which you were referred

Wales, Scotland and Northern Ireland each run their own equivalent, claimed through their own forms — HC5W(T) in Wales, for example.

What NHS dental treatment actually costs

Dental charges are where the four nations have diverged most, and where out-of-date guides are now simply wrong. Wales replaced the banded system entirely on 1 April 2026.

Sources: SI 2026/265; GOV.WALES; nidirect. Note that the printed HC11 booklet dated April 2026 still shows the 2025 English dental figures; the regulations above are the correct source.

Free NHS sight tests

In England you get a free NHS sight test if you are under 16, or 16 to 18 in full-time education, or 60 or over; if you are registered blind or partially sighted; if you have been diagnosed with diabetes or glaucoma; if you are 40 or over and have a parent, sibling or child with glaucoma; if an ophthalmologist has advised you are at risk of glaucoma; if you are eligible for a complex lens voucher; if you are a prisoner on leave; or if you receive a qualifying benefit or hold an HC2. HC3 holders get a reduced-cost test.

In Scotland, NHS eye examinations are free for everyone living in the UK. Scotland is the only nation where this applies.

Can you get help if you already receive benefits?

Sometimes, yes. Receiving a benefit does not automatically rule you in or out. Someone on Universal Credit whose earnings crossed the £435 threshold in their last assessment period is not automatically exempt — but they may still qualify under the Low Income Scheme once housing costs and other circumstances are taken into account. The same applies to a pensioner receiving Savings Credit but not Guarantee Credit.

Because the assessment looks at your whole financial picture, it is worth checking your wider entitlement at the same time. Our benefits checker covers the devolved systems as well as the reserved ones, and Council Tax Reduction is the support most often left unclaimed alongside health costs.

Why applications get delayed

NHSBSA assessments stall for predictable reasons. Before you send the form, check that you have included:

• All household income, including any partner's
• Savings and investments, with current balances
• Housing costs — rent or mortgage, and council tax
• Complete benefit details, including award letters
• Childcare costs, if you pay them

Keep copies of everything you send, along with payslips, benefit letters and pension statements.

Where else to look

Health costs rarely arrive on their own. If money is tight enough that prescriptions are a problem, it is worth checking the rest at the same time.

• Council Tax Reduction — means-tested, run by your council, and separate from the discounts that are not means-tested at all
• Unclaimed money — dormant accounts, lost pensions and Child Trust Funds, all checkable free
• Work Capability Assessment — if a health condition is affecting your ability to work

SortedUK is run by CA Capital Limited. We publish the date every page was checked and the source behind every figure, and we correct pages in public when something changes. This page is general information, not advice about your individual circumstances. Charges and thresholds change, most commonly each April — the verification date at the top tells you how current this page is. Next scheduled review: 1 April 2027.