NHS Prescription Charges and Exemptions in England

In England, most people pay for NHS prescriptions. In Scotland, Wales, and Northern Ireland, prescriptions are free for everyone. This guide explains the English system: what a prescription costs, who pays nothing, how the Prescription Prepayment Certificate can cap your costs, and what happens if you claim a free prescription you are not entitled to. It covers the charging rules only — it gives no advice about any medicine.

What you pay

The NHS prescription charge in England is £9.90 per prescription item. It is charged per item, not per prescription: if your GP prescribes three different items on one form, you pay £29.70. The charge was set on 1 May 2024, when it rose from £9.65, and it has been frozen since — it is frozen for 2025/26 and for 2026/27.

You pay the charge when you collect the prescription from the pharmacy, unless you are exempt or you hold a Prescription Prepayment Certificate. If you are not sure whether you are exempt, check before you claim — the NHS Business Services Authority runs an online checker, and claiming a free prescription you are not entitled to can lead to a penalty charge.

The Prescription Prepayment Certificate

If you pay for prescriptions regularly, a Prescription Prepayment Certificate (PPC) can save you money. A PPC covers all your NHS prescription items for a fixed period, however many you need. For 2026/27, a 3-month PPC costs £32.05 and a 12-month PPC costs £114.50. The 12-month certificate can be paid in 10 monthly direct debits.

The maths is simple: at £9.90 per item, a 3-month PPC pays for itself if you need 4 or more items in 3 months, and a 12-month PPC pays for itself if you need 12 or more items in a year. You can buy a PPC online from the NHSBSA, by phone, or at some pharmacies. Do not mix up the years: in 2025/26 the prices were £31.25 for 3 months and £111.60 for 12 months.

Who gets free prescriptions

You get free NHS prescriptions in England if you are under 16, or aged 16 to 18 and in full-time education; if you are 60 or over; or if you are pregnant or have given birth in the last 12 months and hold a valid maternity exemption certificate (MatEx). You also get them free if you hold a valid medical exemption certificate (MedEx), a valid HC2 certificate under the NHS Low Income Scheme, or a War Pension or NHS Tax Credit exemption certificate — or if you are an NHS inpatient.

You also get free prescriptions if you receive a qualifying benefit and meet its conditions. That includes Universal Credit, where your take-home pay must be £435 or less — or £935 or less if your award includes a child element or limited capability for work. The full list of qualifying benefits, and the conditions for each, is on the NHS website and in leaflet HC11. If your circumstances change — for example, your earnings rise above the limit — your entitlement can change too, so check each time you claim.

Medical exemption certificates

A medical exemption certificate (MedEx) gives free prescriptions to people with certain long-term conditions. The qualifying conditions include diabetes treated with medicine, epilepsy needing continuous anticonvulsive therapy, hypothyroidism, hypoparathyroidism, hypoadrenalism, myasthenia gravis, a permanent fistula, cancer under treatment, and a continuing physical disability that prevents you going out without help.

You apply through your GP, using form FP92A, and the certificate is typically valid for 5 years. If your condition is on the list, ask your GP — many people who qualify do not know the certificate exists. Note that a medical condition on its own does not exempt you from other NHS charges: the MedEx covers prescriptions only, and dental charges have their own rules, covered in the dental guide on this site.

The Low Income Scheme and checking entitlement

If you are on a low income but do not qualify for free prescriptions automatically, the NHS Low Income Scheme may help. You apply with form HC1, and if you qualify you receive an HC2 certificate, which gives free prescriptions — or an HC3 certificate, which gives partial help. Note the difference: an HC2 gives free prescriptions, but an HC3 does not.

Before you claim a free prescription, check that you are entitled. The NHSBSA has an online eligibility checker, and your pharmacist can help. Around 90% of prescriptions dispensed in England are collected free of charge because of exemptions, so the system is generous — but it is also checked. If you claim free prescriptions when you are not entitled, you may be asked to pay the charge plus a penalty. When in doubt, pay the charge and claim a refund later if you turn out to have been entitled.

Sources: NHS Business Services Authority, leaflet HC11 (April 2026); NHS website, prescription charges; NHSBSA, Prescription Prepayment Certificate.