What you pay
In England the NHS prescription charge is £9.90 per item. It is a flat charge, not a price — a £3 medicine and a £300 medicine both cost £9.90 on an NHS prescription.
| Item | Cost |
|---|---|
| Single prescribed item | £9.90 |
| 3-month prepayment certificate (PPC) | £32.05 |
| 12-month prepayment certificate (PPC) | £114.50 |
| 12-month PPC by direct debit | 10 instalments |
"Per item", not per prescription
One prescription form listing three medicines is three charges — £29.70. Different strengths of the same drug count separately. This is why costs escalate so quickly for people managing more than one condition, and why the prepayment certificate exists.
Ask whether it is cheaper over the counter
Some medicines cost less than £9.90 to buy directly from the pharmacy. A pharmacist can tell you when that is the case. It does not apply to anything you need clinical oversight on — but for a common painkiller or antihistamine it is worth asking.
Who pays nothing
Roughly nine in ten prescription items dispensed in England are already dispensed free of charge.
| Group | Evidence needed |
|---|---|
| Aged 60 or over | None — declare on the form |
| Under 16 | None |
| 16 to 18 and in full-time education | None |
| Pregnant, or a baby in the last 12 months | Maternity exemption certificate (MatEx), applied for via your midwife or GP |
| Listed medical condition | Medical exemption certificate (MedEx), applied for on form FP92A through your GP |
| Continuing physical disability preventing going out unaided | MedEx certificate |
| War pension exemption | War pension exemption certificate |
| NHS inpatient | None |
| Qualifying benefits | Income Support, income-based JSA, income-related ESA, Pension Credit Guarantee Credit, or qualifying Universal Credit |
| HC2 certificate | NHS Low Income Scheme certificate |
The medical exemption list is narrower than people expect
A long-term condition does not automatically qualify. Asthma, high blood pressure, high cholesterol, depression and arthritis are not on the medical exemption list, despite requiring lifelong medication. Diabetes requiring medication, epilepsy requiring continuous anticonvulsive therapy, an underactive thyroid needing replacement, cancer under treatment and several endocrine conditions are.
If you have a listed condition, ask your GP for FP92A — the certificate lasts five years and covers all your prescriptions, not just the ones for that condition. If you are on a low income but not on a qualifying benefit, the NHS Low Income Scheme is the route.
Prepayment certificates
A prescription prepayment certificate is a season ticket. For a fixed sum it covers unlimited NHS prescriptions for its duration, whatever you are prescribed.
| Certificate | Cost | Break-even | Payment |
|---|---|---|---|
| 3-month PPC | £32.05 | More than 3 items in 3 months | One payment |
| 12-month PPC | £114.50 | More than 11 items in 12 months | One payment or 10 monthly direct debit instalments |
- Buy online through NHSBSA, by phone, or at many pharmacies.
- You can backdate a PPC by up to one month, which recovers charges paid just before you bought it.
- The direct debit option spreads a 12-month certificate over 10 instalments with no extra cost.
- A PPC covers only NHS prescriptions in England — it has no effect on dental or optical charges.
Does a PPC pay off?
The arithmetic is simple, and worth doing honestly against a full year rather than a good month.
| Items per year | Paying per item | With 12-month PPC | Saving |
|---|---|---|---|
| 6 | £59.40 | £114.50 | PPC costs more |
| 12 | £118.80 | £114.50 | £4.30 |
| 24 | £237.60 | £114.50 | £123.10 |
| 36 | £356.40 | £114.50 | £241.90 |
| 60 | £594.00 | £114.50 | £479.50 |
Two regular medicines is usually the tipping point
Two repeat items collected monthly is 24 charges a year — £237.60 without a PPC, £114.50 with one. If you are on two or more regular medicines and not exempt, the certificate almost always wins.
Why the other nations are free
Health is devolved, so the charge is a policy choice each nation makes separately. Three of the four abolished it.
| Nation | Charge | Abolished |
|---|---|---|
| England | £9.90 per item | — |
| Wales | Free | 2007 |
| Northern Ireland | Free | 2010 |
| Scotland | Free | 2011 |
It follows where you are dispensed, not where you live
A resident of England who has a prescription dispensed in Wales pays nothing. A resident of Scotland having one dispensed in England pays £9.90. The relevant question is always where the pharmacy is.
Refunds and penalties
If you pay while an exemption or a certificate application is pending, ask for an FP57 receipt at the moment you pay. The pharmacy cannot issue one afterwards, and without it you cannot reclaim the charge. Refund claims run on form HC5 within three months.
Penalty charges apply to honest mistakes
NHSBSA cross-checks exemption declarations against benefit and certificate records. A wrong tick can bring a penalty of up to five times the amount owed, capped at £100, plus the original charge — and a further £50 if unpaid on time. Intent is not part of the test, so if you are not certain your exemption is still valid, check before you sign.
Certificates expire. MedEx runs for five years, MatEx to a fixed date, and HC2 and HC3 for between six months and five years. Diary the expiry dates and renew in advance — a lapsed certificate you are still declaring is the most common cause of a penalty.
Common questions
How much is an NHS prescription in 2026?
In England the charge is £9.90 per prescribed item. Prescriptions are free in Scotland, Wales and Northern Ireland.
Who gets free NHS prescriptions in England?
People aged 60 or over, under 16, or 16 to 18 in full-time education; pregnant women and those who have had a baby in the past 12 months with a valid MatEx certificate; people with a listed medical condition holding a MedEx certificate; people with a continuing physical disability who cannot go out without help; war pension exemption holders; NHS inpatients; and people on qualifying benefits or holding an HC2 certificate.
How much is a prescription prepayment certificate?
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 debit instalments.
Is a prescription prepayment certificate worth it?
A 12-month PPC saves money if you need more than 11 prescribed items in a year, and a 3-month PPC if you need more than 3 items in three months. Both cover unlimited NHS prescriptions for their duration.
Which medical conditions give free prescriptions?
The medical exemption list includes conditions such as diabetes mellitus requiring medication, epilepsy requiring continuous anticonvulsive therapy, hypothyroidism requiring thyroid hormone replacement, a permanent fistula requiring dressing, forms of hypoadrenalism including Addison’s disease, hypoparathyroidism, diabetes insipidus, myasthenia gravis, cancer undergoing treatment, and a continuing physical disability preventing you from going out without help. Apply through your GP on form FP92A.
Why are prescriptions free in Scotland and Wales?
Health is devolved. Wales abolished prescription charges in 2007, Northern Ireland in 2010 and Scotland in 2011. England retained the charge. You are charged according to where the prescription is dispensed.
What happens if I wrongly claim free prescriptions?
NHSBSA runs checks and can issue a penalty charge of up to five times the amount owed, capped at £100, plus the original charge. A further £50 is added if it is not paid on time. Penalties apply to honest mistakes, so check before ticking the exemption box.
Where these figures come from
- NHSBSA — help with prescription costs
- NHSBSA — prescription prepayment certificates
- NHSBSA — medical exemption certificates
Charges and thresholds change. We check these figures regularly, but always confirm the current rate with the official source before you rely on it. This page explains entitlements, costs and process — it is not medical advice.
The charge is one thing. Getting the prescription is another.
ViscaCare members get online Doctor access from day one across Ireland, the UK and Europe, with prescriptions issued where clinically appropriate and valid in the jurisdiction you are in.
Related guides
HC2 and HC3 certificates
Full or partial help with prescriptions, dental, sight tests and travel costs.
Read moreNHS Low Income Scheme
Who can apply, the savings limits, and how the HC1 assessment works.
Read moreNHS dental charges
The three bands, who is exempt, and how the nations differ.
Read moreRegister with a GP
What a practice can and cannot ask for, and what to do if you are refused.
Read more