Form HC1 - Free Download
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Claim for help with health and travel costs
• to claim help with paying health/travel costs for:
• HS dental treatment • Sight tests, glasses and contact lenses
• Travel to hospital for HS treatment
You might be able to get them free, or get help with paying for them.
• You should use this form to claim help with the cost of Prison Visits and
expenses prior to your visit.
• to claim help for: • yourself • your partner • your children
• at any time before you need treatment
You don’t have to wait until you need help with paying health costs
Important Note – For people who have reached State Pension qualifying age your
claim will be dealt with by the Pension Service, they can be contacted on 0845 601 8821.
Important Note – If you are living in a care home you may need a different form.
Please contact your local Social Security or Jobs & Benefits office, or if you have reached
the State Pension qualifying age contact the Pension Service on 0845 601 8821.
Do use this form
• you cannot get help if you or your partner have more than:
• £16,000 in property, savings or any other money (don’t count the place where
• £23,250 in property, savings or any other money if you live permanently in a
Note - if you have a partner, their property, savings or any other money
is counted with yours
• you are already entitled to full help with health costs
if you or your
partner are getting:
• Income Support
• Pension Credit Guarantee Credit
• Income-based Jobseeker’s Allowance
• Income-related Employment and Support Allowance; or
• You are named on or entitled to a Tax Credit HS Exemption Certiﬁcate
But, if you paid any health or travel costs before you were getting any of these beneﬁts
or became entitled to your Tax Credit HS Exemption Certificate, read the back cover of
this form to see what to do to claim your money back.
Don’t use this form