Free or Reduced Cost Prescriptions
Some people automatically get free prescriptions. Certain people can get an exemption certificate to obtain free prescriptions. Also, anyone needing regular prescriptions may save money by buying a Prescription Prepayment Certificate.
Note: this leaflet only applies to England because prescriptions are free to all in Northern Ireland, Scotland and Wales. It also only gives a brief summary of free or reduced cost prescriptions and is for guidance only. It is not a full statement of the law and a source of further, more detailed information is given at the end.
Who is entitled to get free prescriptions in England?
- If you are aged 60 or over.
- If you are aged under 16.
- If you are aged 16, 17 or 18 and in full-time education.
- If you are pregnant, or have had a baby in the previous 12 months, and have a medical exemption certificate (see below).
- If you have a listed medical condition and have a medical exemption certificate (see below).
- If you are an NHS inpatient.
- If you (or your partner) get one of the following:
- Universal Credit.
- Income Support.
- Income-based Jobseeker's Allowance.
- Income-related Employment and Support Allowance.
- Pension Credit Guarantee Credit.
- If you are entitled to, or named on, a valid NHS tax credit exemption certificate.
- Some war pensioners - if treatment is connected with the pensionable disability.
- People on a low income who have a certificate HC2 (see below).
- If you get Working Tax Credit or Child Tax Credit, you (and your family) may be entitled to help with NHS health costs.
If you are entitled to free prescriptions, complete the declaration on the back of the prescription and sign it. You may be asked for proof that you are exempt.
Who can get a medical exemption certificate?
If you are pregnant or have had a child in the past year
You need to apply for a Maternity Exemption Card, using form FW8. The form is available from doctors, nurses, midwives and health visitors. You are required to complete the form and your doctor, nurse, midwife or health visitor will sign the form to confirm the information given by you is correct.
The card will last until 12 months after the expected date of the birth (you can apply for an extension if the baby is born late). If you have a Maternity Exemption Card all your prescriptions are free, whatever the medication is for.
People who have certain medical conditions
Although there are many conditions requiring regular medication, only the following qualify for an exemption certificate:
- Treatment for cancer; note this includes treatment for the effects of cancer, or treatment for the effects of a current or previous cancer treatment.
- A permanent fistula requiring dressing.
- Forms of hypoadrenalism such as Addison's disease.
- Diabetes insipidus and other forms of hypopituitarism.
- Diabetes mellitus, except where treatment is by diet alone.
- Myxoedema (underactive thyroid) where thyroid hormone replacement is necessary.
- Myasthenia gravis.
- Epilepsy requiring continuous anticonvulsive medication.
- A continuing physical disability which means you cannot go out without help from another person.
If you have one of the specified conditions ask for an application form, FP92A, from your doctor's surgery. You need to fill it in and your doctor (or an authorised member of the practice staff) will sign to confirm the information you've given is correct. You will then be sent a Medical Exemption Certificate which is valid for five years.
If you have a Medical Exemption Certificate all your prescriptions are free, whatever the medication is for.
How can people on a low income apply for help?
Some people on a low income may qualify for help with prescription charges. Your entitlement to help is based on your circumstances, such as your level of income, savings, etc. You will have to fill in an HC1 form 'Claim for Help with Health Costs' giving various details of your circumstances and then send it off in the prepaid envelope provided.
If you qualify for help, you will be sent an HC2 Certificate for full help, or an HC3 Certificate for partial help, which you will need to produce when paying for your prescription. The certificate will tell you whom it covers and how long it lasts. If your circumstances change for the better, you can continue using the certificate until it expires. If your circumstances change for the worse during the period of the certificate, you should make another claim. If your circumstances will remain unchanged after the time period then make a new claim before the current certificate expires.
Can I claim a refund for a prescription charge I have already paid?
If you are on a low income, but have not yet got your exemption certificate then get a receipt form from the pharmacist when your prescription is dispensed. Note that you cannot get one later. When you get your exemption certificate, send the receipt form to the address on the form to get a refund.
How can regular prescription charges be reduced?
If you do not qualify for exemption you may be able to reduce the cost of your prescriptions by buying a Prescription Prepayment Certificate (PPC). This certificate will cover the cost of all your prescriptions during a particular period.
For example, if you pay for more than three prescription items in three months, or more than 13 items in 12 months, you could save money by buying a PPC.The charge for a single prescription item is £8.20 (April 2015).
A PPC costs £29.10 for three months and £104.00 for 12 months.
You can apply for a PPC:
- By telephone on 0300 330 1341.
- Online at https://apps.nhsbsa.nhs.uk/ppcwebsales/patient.do.
- By completing a form from a pharmacy registered to sell PPCs.
If you pay a prescription charge whilst waiting for a PPC to be issued, you can get a refund. To do this you must get a receipt form from the pharmacist (FP57). You must get the receipt form when you pay for your prescription; you cannot get one later. Fill the receipt form in and send it off to claim the refund.
You have to apply for a refund within three months of paying the prescription charge.
Further reading & references
- Help with Health Costs; NHS Business Services Authority
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Hayley Willacy