Use this form to claim for help with health care costs if you have a low income.
Documents
Form HC1W: claim for help with health costs , file type: PDF, file size: 688 KB
PDF
688 KB
If you need a more accessible version of this document please email digital@gov.wales. Please tell us the format you need. If you use assistive technology please tell us what this is.
Notes for form HC1W , file type: PDF, file size: 732 KB
PDF
732 KB
If you need a more accessible version of this document please email digital@gov.wales. Please tell us the format you need. If you use assistive technology please tell us what this is.
Details
The low income scheme helps people pay for health costs. If you are entitled to NHS treatment and meet certain conditions you may get help with the costs of:
- NHS dental treatment
- sight tests
- glasses and contact lenses
- necessary travel to and from hospital for NHS treatment under the care of a hospital consultant
If you would like to find out if the scheme can help you, try the NHS online checker.
You can request a printed copy of this form via email or by calling the publications order line on 0345 603 1108 (Rydym yn croesawu galwadau’n Gymraeg / We welcome calls in Welsh).