Help with health costs for older people

Help with health costs for older people

Age Concern receives many queries asking if there is any help towards cost of NHS dental treatment, glasses and travel to hospital for those who have retired on a low income but are not eligible for the ‘guarantee credit’ component of Pension Credit.

Note: If you receive the ‘guarantee credit’ component of Pension Credit you will be eligible, and will not need to apply separately to the Health Benefits Division, for -

• free NHS dental treatment;
• vouchers towards the cost of glasses or contact lenses;
• repayment of necessary travel costs to hospital and back for NHS treatment.

This Information Sheet is aimed at those on a low income but whose income exceeds the amount that would entitle them to receive the ‘guarantee credit’ component of Pension Credit. It explains how the Low Income Scheme might help towards cost of NHS dental treatment, glasses and travel to hospital for NHS treatment.

Free NHS Services for Older People

The following services are FREE TO THOSE AGED 60 AND OVER:

• NHS Prescriptions
• NHS sight tests
• NHS Dental check ups if you live in Wales

Anyone with impaired hearing is eligible to receive a NHS hearing aid on FREE LOAN. Speak to your GP if you are concerned about your hearing and believe you would benefit from a hearing test.

NHS Low Income Scheme

This scheme may be able to help if you currently pay for:

• NHS dental treatment;
• Glasses or contact lenses;
• Costs of travel to and from hospital for NHS treatment and check ups while under the care of a hospital consultant.

You may be eligible if you and / or your partner have

• a low income
• capital of no more than £12,000 (£8000 if you are under 60)
• capital of no more than £20,000 if you are permanently in a care home

Please note that if you have a partner, any capital they have is counted with yours when assessing eligibility.

* capital includes cash or savings in a post office, bank or building society account; national savings certificates; premium bonds; shares, unit trusts or other investments and any property you own but not the house you live in.

How to apply if you think you may be eligible for help

Go to your dentist, optician or local social security office or speak to the hospital where you are to be treated and ask for an HC1 form (which includes a stamped addressed envelope). Not all dentists and opticians will have the form but many do.

If you are a couple and believe both of you may be eligible for help, complete only one form. One or both of you may sign the form. If both of you are eligible the Health Benefits Division will send a certificate for each person.

The HC1 form has 15 pages. However you are unlikely to need to complete all sections as it can be used by retired people, working people or students.

A large print version is available by calling 0845 610 1198.

Return the signed and completed HC1 form in the pre-paid envelope provided. Until recently claims were being dealt with by the Health Benefits Division. They are now being dealt with by the Patients Services Division of the Prescription Pricing Authority (PPA). If your prepaid envelope says ‘Health Benefits Division’, it will be re-directed. You should hear from them within 15 working days from the date they receive your form. If you do not hear within this time or have any questions, you can call the PPA helpline on 0845 850 1166 (local call rate).You can also write to them at Sandyford House, Newcastle upon Tyne NE2 1DB.

In response to your application, you will be sent:

• an HC2 certificate
• OR HC3 certificate
• OR an explanation of why you are not eligible for help through this scheme.

HC2 certificate entitles the person named on the certificate to help with the full costs of their NHS dental treatment, maximum value vouchers towards the cost of glasses and reasonable costs incurred when travelling to hospital while under the care of an NHS hospital consultant.

HC3 certificate entitles the person named on the certificate to limited help with the above. The certificate will show the maximum amount you will be expected to pay for NHS dental treatment, towards the cost of glasses or towards transport to hospital while under the care of a NHS hospital consultant.

The certificate usually lasts for 12 months.

What to do when you visit the dentist or optician or have to travel to hospital for treatment

Dentist

Tell the receptionist you want NHS treatment when you make your appointment and let them know if you have a HC2 or HC3 certificate. Take your certificate with you and show it to the receptionist when you arrive for your appointment.

If you have a HC2 certificate - you will be asked to sign the form to say you have completed the treatment but will not be charged.

If you have an HC3 certificate - you will be asked to sign to say you have completed your treatment. You will then pay either the amount that appears on the certificate, the actual charge or the maximum charge you can pay for NHS treatment – whichever is least. eg if your certificate says you should pay £30 and the treatment costs £45 you will only pay £30.

Optician

For the general adult population sight tests should be conducted every 2 years but those over 70 should have a sight test every year. Discuss the frequency of your sight test with the optician.

Not all opticians offer NHS sight tests, some will only offer private tests, so check a NHS sight test is available when you call. The NHS sight test is FREE for those of 60 and over. Confirm with the optician that the test includes the necessary tests for eye diseases that older people are susceptible to such as glaucoma, diabetic retinopathy (a complication of diabetes) and age-related macular degeneration (AMD).

It is also possible to have a FREE NHS sight test at home if you are unable to visit the optician due to illness or disability. However not all opticians offer a home service.

Tell the receptionist when you book your NHS sight test that you have a certificate to help with cost of new glasses.

After your eye test the optician will write a prescription showing the results of the test and the type of lenses you need. You can ask for your own copy of the prescription.

If you are eligible for help towards the cost of glasses, you will be issued

with an optical voucher. If you require two different pairs of glasses – one for reading and one for distance – you are entitled to two vouchers.

You do not have to purchase your glasses from the optician who tested your eyes. You can take your prescription to the optician of your choice. If you did not get a voucher at the time you had your NHS sight test and are purchasing your glasses from a different optician, you will need to ask the optician providing your glasses for a voucher. If this optician does not carry out NHS sight tests, he will not hold voucher forms. Therefore you may have to get your voucher from the optician who conducted your NHS sight test.

The value of a voucher depends on the type of lenses you need – the stronger the lenses the higher the value of the voucher. Vouchers may be for single vision or bifocal lenses or used towards the cost of varifocal or contact lenses.

If you have an HC2 certificate - you will be entitled to the full value of the voucher for your type of lens. If the glasses cost more than the voucher value you will have to pay the difference yourself.

If you have an HC3 certificate - it will indicate the maximum amount you should contribute towards the cost of your glasses. e.g if the certificate says you should contribute £15 and your voucher value is £46.50, you will be allowed £31.50 towards the cost of your glasses.

Help with cost of repairs or replacement glasses under the voucher scheme

If loss or damage has arisen as a result of an illness, speak to your optician. It may be possible to get help if you have an HC2 or HC3 certificate.

General wear and tear and accidental damage will not be covered. Therefore it is advisable to take advantage of any guarantee, after sales service or insurance arrangements for repairs or replacements.

Transport to hospital

If you have an HC2 or HC3 certificate, the hospital is responsible for reimbursing relevant travel costs. Therefore always speak to them before you travel if you have questions about the help you may be entitled to.

If, for medical reasons, you need someone to travel with you, the expenses of your travel companion can only be claimed where they are certified to be necessary in the opinion of a doctor or appropriate health care professional. Always ensure you have the necessary approval before travelling. Please note these certificates do not apply if you are visiting a patient in hospital.

You should aim to travel by the cheapest means of transport available at the time you need to travel. The hospital will decide what is necessary. They will consider public transport, use of a private car based on fuel costs, use of voluntary car schemes. Taxis will be an exception. If a taxi seems to be the only form of transport you could use, discuss this with the hospital before you travel.

Speak to the hospital if you would find it difficult to pay for your transport and then claim it back. They can consider sending payment in advance.

Always take your HC2 or HC3 certificate with you as proof of entitlement.

An HC2 certificate entitles you to a full refund of reasonable costs.

An HC3 certificate will indicate how much you should contribute towards transport costs each time you attend the hospital. eg if HC3 indicates you should pay £10 and your costs are £15, the hospital will reimburse £5.

What to do if you have paid for treatment over the past 3 months and think you may have been entitled to help with the cost through this scheme

If your financial circumstances have not changed since you paid for the dental treatment, new glasses or hospital transport, you may be able to claim a refund at the same time as you return the HC1 application form. Ask for an HC5 refund form and enclose it with your application. The dentist, optician or hospital may have a copy of the HC5 form. The Health Benefits Division will assess whether you are eligible for help through the scheme and let you know if you will get any refund.

The time limit for claiming a refund is 3 months. This time limit may be extended if there are exceptional circumstances for making a late claim.

Note

Some people who work past retirement age may be able to claim Working Tax Credit. In some circumstances they may also get help with health costs. For further information call the Tax Credit helpline 0845 300 3900 or Minicom 0845 300 3909. Both are local call rate numbers.

If you would like to receive this information in large print,

phone 0800 00 99 66 (free call) or write to Age Concern FREEPOST (SWB 30375), Ashburton, Devon TQ13 7ZZ.

Find out more about Age Concern Englandonline at

www.ageconcern.org.uk

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