HELP WITH HEALTH COSTS

Some patients are entitled to claim financial assistance with Health Service dental and ophthalmic charges. To find out if you qualify for help with health costs please click on the relevant section below, use the entitlement checker or refer to the information leaflet and supporting documentation.


Dental

If you are registered for Health Service treatment and meet one of the conditions listed below, you do not have to pay for your Dental treatment:

  • You or your partner are in receipt of Income Support
  • You or your partner are in receipt of Income-based Jobseeker’s Allowance
  • You or your partner are in receipt of Income-related Employment and Support Allowance
  • You or your partner are in receipt of Pension Credit Guarantee Credit
  • You are named on a valid NHS Tax Credit Exemption Certificate
  • You are named on a valid HS Charges certificate (HC2)
  • You are named on a valid HS Charges certificate (HC3) which may entitle you to partial assistance.
  • You are 18 years of age or under
  • You are 18 years of age and in full time education *
  • You are pregnant or have had a baby in the previous 12 months

* If you are registered for Health Service treatment and you are 18 years of age and in full time education you do not have to pay for your HS Dental treatment. In order to qualify under full time education you must be under 19 years of age and undertaking a full time course no higher than Level 3, such as A Level, BTEC National Diploma, AVCE, NVQ Level 3. Degree and BTEC Higher National Diploma courses do not qualify as full time education.


Sight Test

If you are registered for Health Service treatment and meet one of the conditions listed below, you do not have to pay for a HS Sight Test:

  • You or your partner are in receipt of Income Support
  • You or your partner are in receipt of Income-based Jobseeker’s Allowance
  • You or your partner are in receipt of Income-related Employment and Support Allowance
  • You or your partner are in receipt of Pension Credit Guarantee Credit
  • You are named on a valid NHS Tax Credit Exemption Certificate
  • You are named on a valid HS Charges certificate (HC2)
  • You are named on a valid HS Charges certificate (HC3) which may entitle you to partial assistance
  • You are under 16 years of age
  • You are 16, 17 or 18 years of age and in full time education *
  • You are 60 years of age or over
  • You are a diagnosed diabetic or you suffer from diabetes mellitus
  • You have diagnosed glaucoma
  • You are aged 40 years or over and have been advised that you are at risk of glaucoma or a member of your immediate family (parent, brother, daughter, son or daughter) has diagnosed glaucoma
  • You are registered blind or partially sighted
  • You require complex lenses

* If you are registered for Health Service treatment and you are 16, 17 or 18 years of age and in full time education you do not have to pay for your Sight Test. In order to qualify under full time education you must be under 19 years of age and undertaking a full time course no higher than Level 3, such as A Level, BTEC National Diploma, AVCE, NVQ Level 3. Degree and BTEC Higher National Diploma courses do not qualify as full time education.


Glasses

If you are registered for Health Service treatment and meet one of the conditions listed below you are entitled to a GOS Voucher to help towards the cost of glasses:

  • You or your partner are in receipt of Income Support
  • You or your partner are in receipt of Income-based Jobseeker’s Allowance
  • You or your partner are in receipt of Income-related Employment and Support Allowance
  • You or your partner are in receipt of Pension Credit Guarantee Credit
  • You are named on a valid NHS Tax Credit Exemption Certificate
  • You are named on a valid HS Charges certificate (HC2)
  • You are named on a valid HS Charges certificate (HC3) which may offer partial assistance
  • You are under 16 years of age
  • You are 16, 17 or 18 years of age and in full time education *
  • You have been prescribed complex lenses

* If you are registered for Health Service treatment and you are 16, 17 or 18 years of age and in full time education you are entitled to a voucher for help with the cost of glasses. In order to qualify under full time education you must be under 19 years of age and undertaking a full time course no higher than Level 3, such as A Level, BTEC National Diploma, AVCE, NVQ Level 3. Degree and BTEC Higher National Diploma courses do not qualify as full time education.


Universal Credit - Important Information

Universal Credit does not automatically qualify you for help with your health costs. Recipients of Universal Credit must apply for help with health costs via the Low Income Scheme by completing form HC1.

Applications can be obtained from your optician, dental practice or your local Jobs and Benefit Office.

Eligible patients must hold a valid HC2 exemption certificate at the time of treatment.

FIXED PENALTY CHARGES

Every year in Northern Ireland the health service loses several millions of pounds in charges by patients wrongfully claiming exemption from charges for dental treatment, sight tests and glasses.

Whether claimed in error or fraudulently the consequence is less funds for patient care.

The Fixed Penalty Charges Scheme seeks to tackle this issue – and help put Health Service money back where it belongs.

Most people are honest. They are correctly entitled to help and claim properly. If you are entitled to help, you should continue to claim. You won’t have to pay penalty charges.

How is the Penalty Charge calculated?

The fine will be 5 times the charge that should have been paid, up to a maximum of £100, and it must be paid within 28 days. Non-payment will lead to an additional surcharge of 50% of the original Penalty Charge. These penalty charges are payable in addition to the original Health Service charge.

Health and Social Care has a zero tolerance policy towards anyone found committing fraud in order to obtain free health service treatment when they are not entitled. Enforcement action includes the recovery of debts owed through the Small Claims Court. 

FURTHER INFORMATION

If you have any questions on entitlement or penalty charges, you can call our free information line.

HWHC_ADVICE LINE

USEFUL LINKS

GET THE FACTS, NOT A FINE.