NHS Prescriptions Charges – A Guide. 2020-2021

Focus on Disability - For Disabled People, the Elderly and their Carers in the UK

A guide to prescription charges from April 2020 to 2021 for sick and disabled people in the UK. Information on free prescriptions, claiming a refund, pre-payment certificates and exemption certificates for certain medical conditions.

See also:
NHS Dental Costs
NHS Wigs and Fabric Supports

Prescription charging information for England, Scotland, Wales and Northern Ireland

The updated prescription charges for English residents will be £9.15 per Item from 1st April 2020 to 2021.  Scotland, Wales and Northern Ireland have abolished prescription charges for residents

The cost of a prescription pre-payment certificate (PPC), which is valid for three months is £29.65, while the price of an annual PPC is £105.90 (see below).

Prescription Charges in England – People exempt from prescription charges, claiming a refund and general information on charging is set out below.

Focus on Disability - For Disabled People, the Elderly and their Carers in the UK

Prescription Charges and Refunds

It seems to be that the thing about the national health service is that it is free health care so long as you are not ill! as soon as you require medication you have to pay out £9.15 for each item on your prescription. this being the case it is important to understand the system and ensure you are getting the medication as cheaply as you can.

It’s £30.05 for a surgical bra.

Free prescriptions

A charge is made for each item on an NHS prescription currently £9.15. But some people don’t have to pay the charge because of their age, income or medical condition. Patients on regular medication may apply to the health authority for a ‘season ticket’ (pre-payment certificate) for longer periods.

British National Formulary (BNF)

Nobody working in healthcare can afford to be without the latest edition of the British National Formulary. The BNF reflects current best practice as well as legal and professional guidelines relating to the use of medicines. As a result it is used widely as a touchstone reference, and cited in Parliaments and courts as a source of authority.

BMA New Guide to
Medicine & Drugs

BMA New Guide to Medicine
and Drugs

BNF 79 (British National Formulary) March 2020

People who do not have to pay prescription charges include:

  • If you are under 16.
  • If you are under 19 and in full-time education.
  • If you are aged 60 or over.
  • If you (or your partner) gets one of the following:
    • Income Support.
    • Income-based Jobseeker’s Allowance.
    • Pension Credit Guarantee Credit.
  • If you have an NHS tax credit exemption certificate.
  • Some war pensioners – if treatment is connected with the pensionable disability.
  • If you have a prescription exemption certificate (see below).
  • People on a low income who have a certificate HC2 (see below).

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 prescription exemption certificate?

If you are pregnant or have had a child in the past year

Get form FW8 from your doctor, midwife or health visitor to apply for a Maternity Exemption Certificate. The form is sent off to the Prescription Pricing Authority who will issue the certificate.

People who have certain medical conditions

Although there are many conditions requiring regular medication, only the following qualify for an exemption certificate:

  • 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.
  • Hypoparathyroidism.
  • Myasthenia gravis.
  • Myxoedema (underactive thyroid) or other conditions where supplemental thyroid hormone is necessary.
  • Epilepsy requiring regular anti-epilepsy medication.
  • If, because of a permanent disability, you cannot leave your home without help.

If you have one of these conditions, get form FP92A from your doctor’s surgery and fill it in. This is sent to the Prescription Pricing Authority who will issue a Medical Exemption Certificate.

If you have a Medical Exemption Certificate or Maternity Exemption Certificate, all your prescriptions are free, whatever the medication is for.

Prescriptions for contraceptives are also free of charge.

How can people on a low income apply for help?

Some people on a low income may qualify for help with health costs such as prescription charges. Your entitlement to help is based on your circumstances such as your level of income, savings, etc. Use form HC1 ‘Claim for help with health costs’. See below on how to get this form. You have to fill in the form giving various details of your circumstances. If your application is successful, you will receive either certificate HC2 or HC3.

  • Certificate HC2 means that you will not need to pay the following health costs: prescription charges; NHS dental charges; eye tests, glasses and contact lenses; travel to hospital for NHS treatment; wigs and fabric supports.
  • Certificate HC3 provides partial help with some of these health costs.

Certificates are usually valid for six months. If your circumstances remain unchanged after six months then, if necessary, 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 certificate HC2, then get a receipt when you pay for your prescription. The receipt is form FP57. You must get this receipt from the pharmacist when your prescription is dispensed. You cannot get one later. When you get certificate HC2, send the receipt form FP57 to the address on the form to get a refund. (Note: if you are claiming a refund for any other health cost such as dental charges, you need to claim on form HC5.)

How can I get the claim forms?

To get the forms HC1 and HC5 mentioned above:

  • contact your local office of the Department of Work and Pensions (the local Jobcentre Plus or ‘social security’ office) for a claim form. Find your local office in the phone book under ‘Jobcentre Plus’, OR
  • get them from an NHS hospital, OR
  • your dentist or optometrist (optician) may stock them, OR
  • phone the Department of Health Publications Orderline on 0300 123 1002 (minicom 0300 123 1003) nd ask for a form to be sent to you.

Prescription Pre-payment Certificate (PPC)

If you know you’ll have to pay for a lot of NHS prescriptions, it may be cheaper to buy a prescription prepayment certificate (PPC) – effectively a prescription “season ticket”.

A PPC covers all your NHS prescriptions, including NHS dental prescriptions, no matter how many items you need.

But it does not cover the cost of other health items, such as the provision of wigs and fabric supports, which are only provided through the hospital service.

There are 2 PPC options to choose from:

  1. The 3-month PPC costs £29.65 and will save you money if you need more than 3 prescribed items in 3 months
  2. The 12-month PPC costs £105.90 and will save you money if you need more than 11 prescribed items in a year

Telephone advice and order line 0300 330 1341

General Public – Buy or Renew a PPC On-line

What a Prescription Pre-payment Certificate covers

A PPC covers you for all of your own NHS prescriptions, no matter how many items you needIf you have to pay a prescription charge while you are waiting for your PPC, you may get a refund as long as you have an NHS receipt and refund form FP57. The pharmacist or dispensing doctor can only issue an FP57 at the time you pay the prescription charge – they cannot issue you one later. You can claim the prescription charge(s) back up to three months after paying. The FP57 tells you what to do. But remember the PPC itself can only be backdated by one month.

What if it’s cheaper buying your prescribed drug over the counter

One of the topics surrounding NHS prescription charges is that in some cases the drug prescribed, for which you will be paying paying £9.15, can be purchased over the counter without prescription for less.

Pharmacists may point this out when appropriate, however, they run the risk of being reported for so doing

It is important to get to grips with the system to ensure that you are not paying unnecessarily and, when payment is required, to ensure that you are expending the least possible money in the circumstances.

Prescription Charges in Scotland – Free for everyone

English residents can’t go over the the border to get the cheaper prescriptions – you must be a Scottish resident.

Prescription Charges in Wales – Free for everyone

All prescriptions are free in Wales, but only for welsh residents. English residents can’t go over the border to get the free prescriptions.

Prescription Charges in Northern Ireland – Free to everyone

You must be resident in Northern Ireland to get prescriptions for free.


Pharmaceutical Services Negotiating Committee (PSNC) – The latest information on prescriptions and pharmacy issues.