Prescription costs and exemptions.

In England there is a flat NHS charge for each item on a prescription, regardless of what the medicine actually costs. The current charge is £9.90 per item.

The charge is per item, not per prescription. A prescription with three different medicines on it means three charges. If you are exempt, you pay nothing.

Prescriptions are free in Scotland, Wales and Northern Ireland. These rules apply to prescriptions dispensed in England.

You are automatically exempt from NHS prescription charges if you are:

• Aged 60 or over
• Under 16
• Aged 16 to 18 and in full-time education
• Pregnant, or have given birth in the past 12 months, with a valid MatEx certificate
• Holding a valid medical exemption (MedEx) certificate for a listed condition
• Holding a valid war pension exemption certificate for your accepted disability
• An inpatient in an NHS hospital

You may also be exempt on income grounds, for example if you or your partner receive Income Support, income-based Jobseeker's Allowance, income-related Employment and Support Allowance, Pension Credit Guarantee Credit, or Universal Credit within the earnings thresholds. An NHS Tax Credit Exemption Certificate or an HC2 certificate from the NHS Low Income Scheme also gives full exemption.

A medical exemption certificate (MedEx) covers all your prescriptions, not just those for the qualifying condition. Conditions that qualify include a permanent fistula, certain hormone deficiencies such as hypothyroidism and diabetes treated with medication, myasthenia gravis, epilepsy requiring continuous anticonvulsant medication, a continuing physical disability that prevents you leaving home unaided, and cancer, where the certificate covers treatment of the cancer and its effects.

Apply using form FP92A, which your GP practice can give you and sign. Certificates last five years and must be renewed. Keep an eye on the expiry date, because an expired certificate means you will be charged.

If you pay for prescriptions and need more than a handful of items a year, a prescription prepayment certificate (PPC) almost always works out cheaper. It covers all your NHS prescriptions for a fixed period, however many items you need.

As a rough guide, a three-month PPC pays for itself at around four items, and a twelve-month PPC at around twelve items. There is also an HRT-specific prepayment certificate that covers listed hormone replacement therapy items for twelve months at a much lower cost.

You can buy a PPC online through the NHS Business Services Authority, by phone, or ask us in the pharmacy and we will point you in the right direction.

As a UK registered pharmacy we accept every valid NHS exemption and prepayment certificate. When you collect your prescription you will be asked to confirm which exemption applies and to sign the back of the form or confirm electronically.

Please bring your certificate with you, or know the number, the first time you claim. Claiming an exemption you are not entitled to can result in a penalty charge from the NHS, so if you are unsure whether yours is still valid, ask us and we will check before you sign.

Private prescriptions work differently. There is no fixed NHS charge, so you pay the cost of the medicine plus a dispensing fee. We will always tell you the price before dispensing, and you are free to take the prescription elsewhere.

NHS exemption certificates do not apply to private prescriptions or to our private clinic fees. Our service prices are listed on each service page.

If cost is a barrier to getting the treatment you need, tell us. There is often an NHS route, a cheaper equivalent or a prepayment option that helps.

Prescription charging rules are genuinely confusing, and getting them wrong costs people money. Call us on 0208 840 4464 or come in and ask. We will not rush you.

Charges are set nationally and change from time to time, usually in April. We update this page when they do, but the NHS website is always the definitive source.