This information should not be relied upon as legal or professional advice. Read the disclaimer.
NHS Prescription charges
The NHS in England makes charges for certain treatments such as prescriptions. Currently, The National Health Service (Charges for Drugs and Appliances) Regulations 2015, made under powers conferred by the NHS Act 2006, make provision for prescription charges and exemptions in England. From 1 April 2021, the medicine prescription charge for England has been £9.35.
There is a broad system of exemptions from prescription charges, including for those on low incomes and people with some long-term medical conditions. This means, according to a Government answer to an oral Parliamentary Question in October 2019, around 89% of NHS prescription items are dispensed in the community free of charge.
Prescriptions are free of charge in Scotland, Wales and Northern Ireland.
Who is entitled to free prescriptions?
Automatic entitlement to free prescriptions
Individuals are entitled to free prescriptions if they meet one or more of the following criteria:
- are 60 or over
- are under 16
- are 16 to 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 them going out without help from another person and have a valid medical exemption certificate (MedEx)
- hold a valid war pension exemption certificate and the prescription is for an accepted disability
- are an NHS inpatient
Free prescriptions for those receiving benefits
Individuals are also entitled to free prescriptions if they – or their partner – receive, or they’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
- Pension Credit Guarantee Credit
- Universal Credit and meet the criteria
Medical conditions which exempt someone from prescription charges
Individuals are exempt from prescription charges if they have certain medical conditions and hold a valid medical exemption certificate.
A full list of conditions which entitle a person to exemption from prescription charges can be found in the section free prescriptions for certain medical conditions on the NHS page: Who can get free prescriptions.
Patients with one of the specified medical conditions can apply for a medical exemption certificate from their GP. Further information on the process for obtaining a certificate is available from the NHS under the section: How to apply for a medical exemption certificate.
Further help with prescription costs
If an individual is on a low income, they may qualify for help with health costs through the NHS Low Income scheme. This can help pay NHS prescription charges.
Individuals could also save money through a prescription pre-payment certificate (PPC). The National Health Service (Charges for Drugs and Appliances) (Amendment) Regulations 2021 sets out the costs of a PPC:
- A 3-month PPC costs £30.25 (saving an individual money if they need 4 or more prescribed items in the 3 months)
- A 12-month PPC costs £108.10 (saving an individual money if they need more than 11 prescribed items in a year)
Full information on help with health costs is detailed on the NHS Choices website – Get help with health costs.
Checking eligibility for free prescriptions
The NHS has created an eligibility checker which can be used by an individual to work out any entitlement they have for help with prescription costs.
Proposed reform of prescription charge exemptions
On 3 September 2021 the government closed a consultation on Aligning the upper age for NHS prescription charge exemptions with the State Pension age.
The consultation put forward two possible options for change:
- Option A – to raise the qualifying age for free prescriptions to the SPA (currently 66) for everyone.
- Option B – to raise the qualifying age for free prescriptions to the SPA (currently 66) but with a period of protection, which would mean that people in the age range 60 to 65 would continue to receive free prescriptions.
There has been no government response to the consultation. A recent parliamentary question in May 2022 asking what planned timetable is for responding to the consultation received the following response:
No decisions on the proposals have yet been made. We will respond to the consultation and announce our next steps in due course.
For future background for these and other NHS charges please see the House of Commons Library briefing NHS charges.
The Commons Library does not intend the information in this article to address the specific circumstances of any particular individual. We have published it to support the work of MPs. You should not rely upon it as legal or professional advice, or as a substitute for it. We do not accept any liability whatsoever for any errors, omissions or misstatements contained herein. You should consult a suitably qualified professional if you require specific advice or information. Read our briefing for information about sources of legal advice and help.