Read this first — you may not have to pay at all
Before you reach for your card at the pharmacy, check the free list below. Roughly 9 in 10 NHS prescription items in England are actually dispensed free — because so many people are exempt and don't always realise it: everyone aged 60+, all under-16s, pregnancy and new mothers, people with certain long-term conditions, and people on a low income.
And if you do pay regularly, you almost never need to pay £9.90 every time — a prepayment certificate puts a flat cap on the whole year. Take a breath; the numbers below are the most you'll pay, and usually a lot less.
Everything in this guide is the England system. If you live in Scotland, Wales or Northern Ireland, your prescriptions are free — skip to the section near the end.
The England charge — £9.90 per item
In England you pay a set NHS prescription charge of £9.90 per item. That's per item, not per prescription — so if your prescription has three different medicines on it, that's three charges (£29.70). The charge has been frozen at £9.90 for 2026/27 — the second year running it hasn't gone up.
The charge is fixed by the government, so it's the same at every pharmacy — you can't shop around for a cheaper NHS prescription. Some items are always free for everyone, including most contraception, medicines given to you in hospital, and items administered personally by a GP or at a clinic.
Paying for a lot of items? Stop — read the PPC section first
If you pay for more than 3 items in 3 months, or roughly 11–12 items across a year, you're paying more than you need to. A Prescription Prepayment Certificate caps the whole lot — see below before you pay item-by-item again.
Who gets NHS prescriptions free (England)
In England, your NHS prescriptions are free if any of the following apply when the item is dispensed:
Free because of your age, pregnancy or condition
- Aged 60 or over, or under 16, or 16, 17 or 18 and in full-time education (you may be asked to show proof of education).
- Pregnant, or have had a baby in the last 12 months — you'll need a valid maternity exemption certificate (MatEx). Ask your midwife, GP or health visitor to apply for you. This covers all your prescriptions, not just pregnancy-related ones.
- You have a listed medical condition and a valid medical exemption certificate (MedEx) — it's the certificate, not the condition, that gives free prescriptions. Listed conditions include diabetes treated with medication (not diet alone), epilepsy needing continuous anticonvulsant therapy, cancer (and its effects/treatment), a permanent fistula needing dressing or an appliance, hypoadrenalism (e.g. Addison's disease), diabetes insipidus and other hypopituitarism, myasthenia gravis, hypoparathyroidism, myxoedema (and other thyroid conditions needing replacement therapy), or a continuing physical disability that means you can't go out without help. Ask your GP to complete form FP92A.
- You have a war pension exemption certificate and the prescription is for your accepted disability.
Free because of benefits or low income
You (or your partner) get one of these:
- Pension Credit — the Guarantee Credit part (Savings Credit alone doesn't count).
- Income-related Employment and Support Allowance.
- Universal Credit — but only if your earnings in your last assessment period were £435 or less, or £935 or less if your award included a child element or you (or your partner) had limited capability for work. Being on UC does not automatically make prescriptions free — check your award notice first.
- A valid NHS tax credit exemption certificate, or an HC2 certificate from the NHS Low Income Scheme (a partial HC3 certificate may reduce, not remove, what you pay).
New for 2026 — and why you must check before ticking "exempt"
From 15 April 2026, Income Support and income-based Jobseeker's Allowance stopped being valid prescription exemptions (these legacy benefits are being moved to Universal Credit). If you used to claim free prescriptions on one of those, you now need to qualify another way.
If you tick the exemption box on the back of the prescription when you weren't entitled, the NHS can issue a penalty charge (the £9.90 you owe plus a penalty on top, and a surcharge if unpaid). If you're not sure — especially on Universal Credit — check your latest award notice, or use the NHS eligibility checker, before you sign. On a low income but not on a qualifying benefit? Apply to the NHS Low Income Scheme — you don't have to be on benefits to get an HC2.
The Prepayment Certificate (PPC) — pay regularly, pay less
A PPC is a flat fee that covers all your NHS prescriptions for a set period — however many items you need. You pay once, then everything's covered. The prices are frozen for 2026/27:
| Certificate | Price (2026/27) | Worth it if you pay for… |
|---|
| 3-month PPC | £32.05 | More than 3 items in 3 months (4+ items = a saving). About the cost of 3¼ single items. |
| 12-month PPC | £114.50 | 11 or more items in a year (12+ = a saving). Can be paid by 10 monthly Direct Debit instalments. |
| HRT PPC | £19.80 / year | 3 or more prescribed HRT items a year — covers listed HRT medicines only (see below). |
The simple maths
One item at £9.90, paid every month, is £118.80 over a year — more than a 12-month PPC at £114.50. So if you take even one regular monthly medicine all year, a 12-month PPC already saves you money. Take two or more and the saving is large.
A PPC starts from the date you choose (you can backdate a few days or set a future start) and you can buy it online at nhsbsa.nhs.uk/ppc or by phone on 0300 330 1341. Keep the certificate number to hand for the pharmacy.
The HRT PPC — much cheaper if it's just HRT
If you only take hormone replacement therapy (HRT) medicines, there's a separate, far cheaper certificate. The HRT PPC costs a one-off £19.80 (the price of two single items) and covers an unlimited number of listed HRT medicines for 12 months, however many you collect. It pays for itself if you're prescribed HRT 3 or more times a year.
HRT PPC — the catch to know
The HRT PPC only covers listed HRT items. If your GP also prescribes other regular medicines, those aren't covered — so a standard PPC (which covers everything) may suit you better. Buy or check the covered-medicines list at nhsbsa.nhs.uk/hrt-ppc or call 0300 330 2089.
Claiming a refund if you overpaid
Paid for a prescription but were actually entitled to it free, or already had a valid PPC at the time? You can claim the money back.
- At the pharmacy, when you pay, ask for an NHS receipt — form FP57. You can't claim a refund without it, and you have to ask at the time you pay (the pharmacy can't issue one later).
- The FP57 explains how to claim. You must send your claim within 3 months of paying.
- If you bought a PPC that started after you'd already paid for items in the same period, you can usually reclaim those earlier charges too — ask when you buy the PPC.
Quick note on the forms
The FP57 form is the prescription refund receipt — different from the dental refund form (HC5(D)). For help with any NHS health cost — prescriptions, dental, eye care, travel to hospital — call the NHS help with health costs line on 0300 330 1343 (Mon–Fri 8am–6pm, Sat 9am–3pm).
Scotland, Wales & Northern Ireland — free for everyone
This is the fact most English searchers don't know applies elsewhere: NHS prescriptions are completely free for everyone in the other three UK nations — whatever your age, income or condition. Only England still charges.
Free across the rest of the UK
Scotland. All NHS prescriptions are free for everyone — charges were abolished in 2011. There's nothing to claim and no exemption to prove. See nhsinform.scot.
Wales. NHS prescriptions have been free for everyone since 2007.
Northern Ireland. NHS prescriptions have been free for everyone since 2010 — see nidirect.gov.uk. Crossing borders: a prescription written and dispensed within Scotland, Wales or NI is free. An English prescription form taken to a pharmacy in England carries the £9.90 charge unless you're exempt — so the charge is really about where it's dispensed.
Do this right now
Whether you're paying too much or just want to make sure you're not — here's the calm order:
Check if it's free · cap the cost · claim back
- Check if you pay nothing. Over 60, under 16, pregnant/new mother, a listed condition, or on a qualifying benefit (incl. UC under the earnings limit)? Your prescriptions are free — get a MatEx or MedEx certificate, or apply to the NHS Low Income Scheme for an HC2.
- If you pay regularly, buy a PPC. More than 3 items in 3 months, or 12+ a year? A PPC caps the cost — £32.05 (3 months) or £114.50 (year, by Direct Debit). Just HRT? The HRT PPC is £19.80 a year. Buy at nhsbsa.nhs.uk/ppc or call 0300 330 1341.
- Paid but should have been free? Ask the pharmacy for an FP57 receipt when you pay and claim it back within 3 months. Help with health costs: 0300 330 1343.
- In Scotland, Wales or NI? Your prescriptions are free — there's nothing to pay and nothing to claim.
Help with prescription costs is just one of many UK schemes people miss — check what else you may be owed.
For free, independent help: Citizens Advice can explain help with health costs, and the NHSBSA free NHS prescriptions page and eligibility checker show exactly what you're entitled to. NHS help with health costs line: 0300 330 1343.