In England only some people are entitled to free NHS prescriptions and the rules are easy to get wrong. In the first six months of 2023 around 250,000 people were told they were being fined for wrongly claiming free NHS prescriptions. In England each item on a prescription costs £9.65 unless you are exempt. If you do not pay you will be charged nearly £58 for one item – made up of £9.65 plus five times that as a penalty. For three items wrongly claimed free you must pay £28.95 plus £100 – the maximum penalty allowed.



If you are aged 60 or more, or under 16, NHS prescriptions are free. They are also free for people aged 16 to 18 in full-time education. Pregnant women and mothers with a baby under one receive free prescriptions if they get a maternity exemption certificate from a doctor, midwife or health visitor. People on certain means-tested benefits such as Income Support or the means tested versions of Jobseeker’s Allowance or Employment and Support Allowance also get prescriptions free. But people on Universal Credit need to pass a further test. If they have a job, their earnings after tax must be less than £435 in their last monthly assessment period. This means that, if their earnings vary, they can move in and out of entitlement. A higher threshold of £935 applies to those with a child or with limited capability for work. People on tax credits must also fulfil extra conditions including having a child or a disability and an annual income below £15,276. No wonder people get them wrong!

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People with specified conditions including cancer, diabetes or epilepsy are usually exempt as are those with permanent disabilities that prevent them going out alone. They all need a medical exemption certificate from their GP. But many long-term conditions do not bring exemption. If you are not exempt then a three- or 12-month prepayment certificate is cheaper; if you will need more than three items in three months it costs £31.25; more than 11 items in 12 months and you’ll pay £111.60. You must order in advance.

In Scotland, Wales and Northern Ireland, NHS prescriptions are free for everyone.

For more information go to: – search “free prescriptions” or “prepayment certificate”.

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