Download HC1 Claim Form for Free

The HC1 Claim form is a pretty comprehensive and detailed template. The whole template has four pages, and the first two pages are the knowledge and information about the HC1 form, which can help you know more about it and instructs you on how to fill the form. The last two pages are the HC1 chart that you are going to fill. This template is free to download. If you are interested in this one, you can visit our website.

(4.1 based on 812 votes)
HC1 (SC)
Note - If
you are getting Income Support, Pension Credit Guarantee Credit, income-based
Jobseeker’s Allowance, income-related Employment and Support Allowance, Universal Credit or
have a Tax Credit Exemption Certificate you are already entitled to full help with these health costs,
you don’t need to fill in this form - when you get treatment tell the practitioner which benefit /
credit you are getting. You may be asked for evidence.
Do you find it difficult to pay for:
NHS prescriptions;
NHS dental treatment;
NHS wigs and fabric supports;
sight tests, glasses or contact lenses; or
travel to receive NHS treatment if referred by a doctor (GP or hospital doctor) or dentist?
You might be entitled to help with these health costs through the NHS Low Income
Scheme
Claim for help with health costs
Do you live in a care home and:
the stay is permanent and the local authority helps you with the cost - use this claim form;
the stay is permanent and you pay the full cost yourself (this might be with the help of
relatives or friends or a charity). You might get help with your health costs if you have less
than £23,250 in savings, investments or property - use claim form HC1;
the stay is temporary. You might get help with your health costs if you have less than
£16,000 in savings, investments and property - use claim form HC1.
You can get a claim form HC1 by phoning 0300 123 0849.
Note - If you live permanently in a care home and you have a partner and they need help
with their health costs, they should use their own claim form HC1(SC) or an HC1, whichever is
appropriate.
Have you recently left Local Authority Care and:
you are supported by a local authority - use this claim form;
you are not supported by a local authority. You might get help with your health costs if you
have less than £16,000 in savings, investments or property - use claim form HC1;
you have a partner. You might get help with your health costs if together you have less
than £16,000 in savings, investments or property - use claim form HC1.
You can get a claim form HC1 by phoning 0300 123 0849.
You can claim at any time.
Do not wait until you need treatment. If you need help or have any
questions about filling in this form, you can phone our customer enquiry line on 0300 330 1343. If
English is not your first language, phone this number and we will provide an interpretation service
over the phone.
HC1 Claim Form
 1 / 4 >