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NHS in England - help with health costs

Get help with prescription costs

Prescription prepayment certificates (PPC) are available in England and they can save you money.

NHS prescription costs

  • The current prescription charge is £8.40 per item (£16.80 per pair of elastic hosiery).
  • A three monthly PPC is £29.10 and could save you money if you need more than three prescribed items in three months.  
  • A 12-month certificate is £104.00 and could save you money if you need more than 12 prescribed items in a year.

PPCs are available by 10 monthly direct debit instalment payments. The prescription prepayment certificates allow anyone to obtain all the prescriptions they need for £2 per week. 

Find out more about the prescription prepayment certificate.

If you need to access the services below then medicines are free:


Who is entitled to free prescriptions?

You can get free NHS prescriptions if, at the time the prescription is dispensed, you:

  • are 60 or over
  • are under 16
  • are 16-18 and in full-time education
  • are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)  
  • have a specified medical condition and have a valid medical exemption certificate (MedEx)
  • have a continuing physical disability that prevents you from going out without help from another person and have a valid MedEx
  • hold a valid war pension exemption certificate and the prescription is for your accepted disability
  • are an NHS inpatient

You are also entitled to free prescriptions if you or your partner – including civil partner – receive, or you're under the age of 20 and the dependant of someone receiving:

  • Income Support
  • Income-based Jobseeker’s Allowance
  • Income-related Employment and Support Allowance, or  
  • Pension Credit Guarantee Credit 
  • Universal Credit and meet the criteria 

If you're entitled to or named on:

  • a valid NHS tax credit exemption certificate – if you don't have a certificate, you can show your award notice; you qualify if you get Child Tax Credits, Working Tax Credits with a disability element (or both) and have income for tax credit purposes of £15,276 or less
  • a valid NHS certificate for full help with health costs (HC2)

People named on an NHS certificate for partial help with health costs (HC3) may also get help.

 Find out more about the NHS Low Income Scheme (LIS).

Medical exemptions

People with certain medical conditions can get free NHS prescriptions if:

  • they have one of the conditions listed below, and
  • they hold a valid medical exemption certificate.

Medical exemption certificates are issued on application to people who have:

  • a permanent fistula (for example caecostomy, colostomy, laryngostomy or ileostomy) requiring continuous surgical dressing or requiring an appliance
  • a form of hypoadrenalism (for example Addison's disease) for which specific substitution therapy is essential
  • diabetes insipidus or other forms of hypopituitarism
  • diabetes mellitus, except where treatment is by diet alone
  • hypoparathyroidism
  • myasthenia gravis
  • myxoedema (that is, hypothyroidism requiring thyroid hormone replacement)
  • epilepsy requiring continuous anticonvulsive therapy
  • a continuing physical disability which means the person cannot go out without the help of another person. Temporary disabilities do not count even if they last for several months

Or are undergoing treatment for cancer:

  • including the effects of cancer, or
  • the effects of current or previous cancer treatment

Also read the medical exemption certificate FAQ.

How to apply for a medical exemption certificate

To apply for a medical exemption certificate ask your doctor for an FP92A form. Your GP, hospital or service doctor will sign the form to confirm that your statement is correct. At your GP's discretion, a member of the practice who has access to your medical records can also sign the form.

Your certificate will be valid from one month before the date that the NHS Business Authrority receives the application form.

The MedEx lasts for five years and then needs to be renewed. You may receive a reminder that your certificate needs to be renewed. If you don't receive a reminder, it is your responsibility to ensure that it is renewed.

You can find more information about the application process and refunds on the NHS Business Authority's website.

Free prescriptions for cancer patients

Prescription charges for cancer patients were abolished on April 1 2009.

Exemption certificates will be issued to those applicants who, in their doctor's judgement, are receiving treatment for:

  • cancer
  • the effects of cancer, or
  • the effects of current or previous cancer treatment

Guidance about the extension of the list of medical conditions has been issued to doctors. It includes guidance on who the new medical exemption is intended to cover. 

Exemption for renal dialysis patients

Any renal dialysis patient who has a permanent fistula (permanent means lasting indefinitely) that requires an appliance or surgical dressing, is entitled to medical exemption if they have completed application form FP92A and a doctor has signed the form to confirm the condition. Whether or not you have a permanent fistula that requires an appliance or surgical dressing is a matter for your doctor's clinical judgement.

The criteria are met where there is a clinical need for a permanent fistula to be covered by a surgical dressing (for example between haemodialysis treatments) or by an appliance (such as a catheter for peritoneal dialysis).

Exemption for pregnant women

If you are pregnant, or have had a baby in the last 12 months, you get free:

  • NHS prescriptions, but only if you have a valid maternity exemption certificate (MatEx)
  • NHS dental treatment if, when you are accepted for a course of treatment, you are pregnant or have had a baby in the previous 12 months

To apply for your maternity exemption certificate (MatEx) ask your doctor, nurse, midwife or health visitor for form FW8. You complete parts 1 and 2 of the form and your doctor, midwife or health visitor signs it to confirm that the information given by you is correct.

Your MatEx will last until 12 months after the expected date of birth of your baby. If your baby is born early you can continue to use your MatEx until the certificate expires. If your baby is born late you can apply for an extension. If you apply after your baby is born, your MatEx will run for 12 months from your baby’s birth.

For more information on how to apply for a MatEx visit the NHS Business Services Authority website. 

I am on a low income, how can I get help with NHS charges?

If you are on a low income you may be eligible to receive financial help through the NHS Low Income Scheme. To apply for an HC2 certificate, you should complete form HC1, which is available from Jobcentre Plus offices or most NHS hospitals. Your doctor, dentist or optician may be able to give you one, too. You can also get an HC1 form by calling 0300 123 0849.

Whether you qualify for help is based on a comparison between your weekly income and assessed requirements at the time the claim is made. For more information about requirements visit NHS: help with health costs.

You will qualify for a full help HC2 certificate (which includes free NHS prescriptions) if your income is less than or equal to your requirements, or your income is greater than your requirements by no more than half the current English prescription charge.

You will qualify for a limited help HC3 certificate if your income is greater than your requirements by more than half the current English prescription charge. The HC3 certificate shows how much you have to pay towards your health costs.

Certificates are usually valid for periods of between six months and five years, depending on your circumstances.

Find out more about the NHS Low Income Scheme (LIS).

How can I claim a refund?

Ask your pharmacist, hospital or doctor for the refund form (FP57) when you pay for your prescription. You can't get one later. You have to apply for a refund within three months of paying the prescription charge.

If you receive Universal Credit and meet all the criteria to be entitled for help with health costs but didn't get a refund form (FP57), contact the NHS Business Services Authority who will consider applications for refunds on a case by case basis.

If you have paid for a prescription prepayment certificate (PPC) and have become exempt from paying for prescriptions, you may be able to get some or all of the money back for your PPC.

An explanation of how to claim a refund of your PPC fee can be found on the NHS Business Services Authority website. You can also obtain the leaflet from the DH publications order line on 0300 123 0849.

Important numbers

Dental services helpline – 0300 330 1348

NHS Low Income Scheme helpline – 0300 330 1343

Prescription services helpline – 0300 330 1349

Queries about medical exemption certificates – 0300 330 1341

Queries about prescription prepayment certificates (PPCs) – 0300 330 1341

Queries about tax credit certificates – 0300 330 1347

Call 0300 123 0849 to order a paper copy of the HC12, HC5 and HC1 (SC) forms

Call 0300 330 1343 for all other queries

Page last reviewed: 01/04/2016

Next review due: 01/04/2018