NHS prescription charges: who pays in England and how a prepayment certificate works
Published · 3 min read · Figures checked . UK rules and rates change, so check the official sources below before you act.
In England most working-age adults pay a flat charge for each NHS prescription item, while Scotland, Wales and Northern Ireland do not charge. This guide explains who is exempt, what the charge is, and how a prepayment certificate works.
Who this guide is for
This guide is general information for people who get NHS prescriptions dispensed in England. It does not cover dental or eye costs, or private prescriptions, which are priced differently. It is not advice for your own situation.
The figures below are the ones published by the NHS and the NHS Business Services Authority (NHSBSA) as of 13 October 2026, the date they were checked.
The charge in England
The NHS says the current prescription charge in England is £9.90 per item. The charge applies to each medicine on a prescription, so a prescription with three medicines means three charges.
Some items are always free, including contraceptives and medicines given to hospital inpatients.
Who gets free prescriptions in England
NHSBSA lists several groups who are entitled to free NHS prescriptions in England.
- People under 16, and people aged 16, 17 or 18 who are in full-time education.
- People aged 60 or over.
- People who get certain benefits. Universal Credit counts only in some cases, because it depends on take-home pay in the last assessment period. Pension Credit counts if the person or their partner gets the Guarantee Credit, with or without Savings Credit, but not Savings Credit alone.
- People with a valid medical exemption certificate, a maternity exemption certificate (pregnant, or had a baby in the last 12 months), or a valid war pension exemption certificate for their accepted disability.
- People with an HC2 certificate from the NHS Low Income Scheme. An HC3 certificate gives partial help.
NHSBSA says New Style Jobseeker's Allowance and New Style Employment and Support Allowance do not give automatic entitlement, but people on them may be able to get help through the NHS Low Income Scheme.
What a prepayment certificate is
A prescription prepayment certificate (PPC) is a way of paying in advance for NHS prescriptions in England. Once you hold one, you do not pay the per-item charge for the period it covers. NHSBSA gives the price as £32.05 for a 3 month certificate and £114.50 for a 12 month certificate.
The NHS says a PPC may be cheaper if you expect to pay for many prescriptions. As a simple sum, £114.50 is about 11.6 items at £9.90, and £32.05 is about 3.2 items. So a 12 month certificate costs less than paying item by item once more than 11 items are needed in the year, and a 3 month certificate once more than 3 items are needed in the period. Your own numbers will vary.
A 12 month PPC can be paid in 10 monthly Direct Debit instalments, or paid in full by card or at a pharmacy. Some pharmacies sell PPCs, and you can also buy one online through NHSBSA.
If you paid but were entitled to free prescriptions
The NHS says you can only get a refund if you were given an FP57 refund receipt at the time you paid. You take it, with evidence of your entitlement, to a community pharmacy within three months of paying.
Scotland, Wales and Northern Ireland
The NHS says prescriptions are free in Scotland and Wales. The Northern Ireland government's nidirect site says prescriptions are free in Northern Ireland, with no eligibility test. The rules in this guide about charges and PPCs apply to England.
Check before you act
Charges, prices and exemption rules can change, so it can be worth confirming them on the official pages linked below. If a bill is hard to afford, the NHS Low Income Scheme and Citizens Advice can explain what help may exist.
Sources
For information only. See our disclaimer and editorial standards. Spotted an error? Tell us.
