FORM HC-5 EMPLOYEE NOTIFICATION TO EMPLOYER FOR CALENDAR YEAR 2024 Use this form if the employee works at least 20 hours per week and: Works for 2 or more employers** or Terminates an exemption or Claims an exemption or waiver from health care coverage or Changes principal and/or secondary employer designation**

You can get a form by calling 0300 123 0849 or visiting www.nhsbsa.nhs.uk/healthcosts. Send this form with the HC1 form to NHS Business Services Authority, Bridge House, 152 Pilgrim Street, Newcastle upon Tyne NE1 6SN.

Pension Credit Guarantee Credit – send this form to the Pension Centre who dealt with your claim you can claim a refund. If you get one of these benefits alongside another benefit you wil

Refunds must be claimed within 3 months of the date you made payment. Download, print and return the relevant form: You can also order a form online and we'll post it to you. The HC5 (W) form cannot be ordered online. You must call 0300 330 1343 and we'll post the form to you.

What can you claim for? Use this form to claim back the cost of NHS Dental Treatment. practice was in England. You may also have to fill in an HC1 claim form for the NHS Low In nd the date you paid it. To claim a refund you must complete this form and inclu

If you paid for NHS treatment before finding out you were entitled, you may be able to claim a refund. Refunds must be claimed within 3 months of the date you made payment. To apply, download, print and return an HC5 refund form with your original receipt. The HC5 form tells you where to send it. We cannot accept proof of payment from:

You will need to complete an HC5(T) form to apply for a refund. This guide will help you fill in your HC5(T) form. If you live in England, you can also order the form online and we’ll post it to you. Or you might be able to get an HC5 from NHS hospitals, GP practices or Jobcentres.

HS dental treatment glasses or contact lenses: if you paid for a repair or replacement because your glasses/contact lenses were lost or damaged, your local NHS Board has to agree that the loss or damage was because of illness before. you can get a refund. Send a note with this form to tell us how the lo.

If you’re unable to claim a refund at the time of treatment, complete a HC5 (T) and return this with the original travel receipts. The HC5 form tells you where to send it. You can include multiple trips on one HC5 (T) but must complete a new form for each place you have travelled.

Use this form to claim back the cost of a sight test, glasses or contact lenses on low income grounds. For glasses and contact lenses, the maximum refund anyone can have is the voucher value that matches their prescription.