NHS Services & Rules
Who gets free NHS prescriptions?
By Pick My Pharmacy Editorial · Updated 9 July 2026
Age-based exemptions — automatic, no certificate needed
Age exemptions are the simplest: everyone aged 60 or over, everyone under 16, and 16-to-18-year-olds in full-time education pay nothing for NHS prescriptions in England. There is no certificate to apply for — you tick the relevant box on the back of the prescription (or confirm digitally) and may be asked to show proof of age, so it is worth carrying something with your date of birth. Between them, age exemptions cover a large share of all prescriptions dispensed: most regular medication is taken by older people, and children's prescriptions are always free. If you are 59 and paying for several regular medicines, note that a 12-month prepayment certificate might still save money in your final charging year — check the break-even maths before your birthday.
Medical and maternity exemption certificates
If you are pregnant or gave birth in the last 12 months, a maternity exemption certificate (MatEx) — arranged through your midwife, GP, or health visitor — makes all your NHS prescriptions free, not just pregnancy-related ones. A medical exemption certificate (MedEx) does the same for people with listed conditions, including diabetes treated with medication, epilepsy needing continuous treatment, cancer (including treatment for its effects), hypothyroidism requiring thyroid hormone replacement, Addison's disease, myasthenia gravis, hypoparathyroidism, a permanent fistula needing dressings, and continuing physical disability that prevents going out without help. Your GP or clinic confirms the condition and the certificate is issued by the NHS Business Services Authority, typically for five years. The condition list is specific and has not kept pace with every long-term illness — asthma and many heart conditions are notably absent — so many people with genuine long-term conditions still pay unless another exemption applies.
Low income and benefits
Several benefits bring automatic free prescriptions in England: Income Support, income-based Jobseeker's Allowance, income-related Employment and Support Allowance, Pension Credit Guarantee Credit, and Universal Credit if your earnings in the relevant assessment period were within the qualifying limit. (Tax credits — and the NHS Tax Credit Exemption Certificates that came with them — ended in April 2025 when claimants moved to Universal Credit.) Separately, the NHS Low Income Scheme helps people who don't receive those benefits but have low income and savings: apply with form HC1, and you may receive an HC2 certificate (full help — free prescriptions) or HC5 (partial help). Students, part-time workers, and pensioners just above benefit thresholds are classic HC2 candidates who often don't realise they qualify. If you are unsure which category fits you, our free prescription checker walks through the questions in a minute.
Scotland, Wales, and Northern Ireland — and the fine print
Prescription charges were abolished in Wales (2007), Northern Ireland (2010), and Scotland (2011), so NHS prescriptions dispensed there are free for everyone, with no exemption boxes to tick. The fine print appears when you cross borders: if you live in Scotland or Wales but have a prescription dispensed at a pharmacy in England, the English charge can apply — patients in this position can use an entitlement card or English exemption where eligible. The reverse is friendlier: an English resident collecting a prescription in Scotland pays nothing. One final caution for England: only claim an exemption you actually hold. Exemption declarations are checked against NHS records, and a wrong claim can bring a penalty charge notice of up to £100. If in doubt, pay and ask for an FP57 refund receipt, then claim back once your exemption is confirmed — and ask the pharmacy team, who deal with these rules all day.
People Also Ask
Are prescriptions free with asthma in England?
No — asthma is not on the medical exemption list, so most people with asthma pay unless another exemption applies. If you use several items regularly, a prepayment certificate usually cuts the cost significantly.
Do I get free prescriptions on Universal Credit?
Only if your earnings in the relevant assessment period were within the qualifying limit (higher if your award includes children or limited capability for work). Check your latest statement before ticking the exemption box — getting it wrong can mean a penalty notice.
How do I get a medical exemption certificate?
Ask at your GP practice. They confirm you have a listed condition and the application goes to the NHS Business Services Authority, which issues the MedEx certificate — usually valid for five years. It covers all your NHS prescriptions, not just those for the exempting condition.
Are contraceptives free on prescription in England?
Yes — contraceptives prescribed on the NHS are free for everyone, with no exemption certificate needed. Pharmacies operating the NHS Pharmacy Contraception Service can also supply ongoing oral contraception free without a GP visit.
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This article is general information for UK patients, not medical advice, and NHS rules and charges change — confirm current rules on nhs.uk or speak to a pharmacist or GP before acting. For urgent medical help call NHS 111, or 999 in an emergency. Price figures are indicative benchmarks from ourmethodology.