Help with health costs

The following items are supplied free of charge:

• Medication administered at a hospital or an NHS walk-in centre.
• Prescribed contraceptives.
• Medication personally administered by a GP.
• Medication supplied at a hospital or primary care trust (PCT) clinic for the treatment of a sexually transmitted infection or tuberculosis.

You can get free NHS prescriptions if, at the time the prescription is dispensed, you:

• are 60 or over
• are under 16
• are 16-18 and in full-time education
• are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)
• have a specified medical condition and have a valid medical exemption certificate (MedEx)
• have a continuing physical disability that prevents you from going out without help from another person and have a valid MedEx
• hold a valid war pension exemption certificate and the prescription is for your accepted disability
• are an NHS inpatient

You are also entitled to free prescriptions if you or your partner (including civil partners) are named on, or are entitled to, an NHS tax credit exemption certificate or a valid HC2 certificate (full help with health costs), or you receive either:

• Income Support
• Income-based Jobseeker’s Allowance
• Income-related Employment and Support Allowance, or
• Pension Credit Guarantee Credit

Find out more about the NHS Low Income Scheme (LIS).

If you are pregnant, or have had a baby in the last 12 months, you get free:

• NHS prescriptions, but only if you have a valid maternity exemption certificate (MatEx)
• NHS dental treatment if, when you are accepted for a course of treatment, you are pregnant or have had a baby in the previous 12 months

To apply for your maternity exemption certificate (MatEx) ask your doctor, nurse, midwife or health visitor for form FW8. You complete parts 1 and 2 of the form and your doctor, midwife or health visitor signs it to confirm that the information given by you is correct.

Your MatEx will last until 12 months after the expected date of birth of your baby. If your baby is born early you can continue to use your MatEx until the certificate expires. If your baby is born late you can apply for an extension. If you apply after your baby is born, your MatEx will run for 12 months from your baby’s birth.

For more information on how to apply for a MatEx visit the NHS Business Services Authority website.

Medical exemption (MedEx) certificates are issued on application to people who have:

• a permanent fistula (for example caecostomy, colostomy, laryngostomy or ileostomy) requiring an appliance or continuous surgical dressing
• a form of hypoadrenalism (for example Addison's disease) for which specific substitution therapy is needed
• diabetes insipidus or other forms of hypopituitarism
• diabetes mellitus, except where treatment is by diet alone
• hypoparathyroidism
• myasthenia gravis
• myxoedema (hypothyroidism requiring thyroid hormone replacement)
• epilepsy requiring continuous anticonvulsive therapy
• continuing physical disability that prevents the person from going out without help from another person. Temporary disabilities do not count even if they last for several months

You are also issued with a MedEx if you are undergoing treatment for cancer. This includes treatment for the effects of cancer or for the effects of cancer treatments.

To apply for a MedEx certificate ask your doctor for an FP92A form. Your GP, hospital or service doctor will sign the form to confirm that your statement is correct. At your GP's discretion, a member of the practice who has access to your medical records can also sign the form.

Your certificate will be valid from one month before the date that the NHS Business Services Authority receives the application form.

The MedEx lasts for five years and then needs to be renewed. You may receive a reminder that your certificate needs to be renewed. If you don't receive a reminder, it is your responsibility to ensure that it is renewed.

Prescription charges for cancer patients were abolished on April 1 2009.

Patients being treated for cancer, including the effects of cancer or the effects of cancer treatment, can apply for a medical exemption (MedEx) certificate. If you have cancer ask your doctor for an application form. This will need to be countersigned by your GP, hospital or service doctor (or, at your GP's discretion, a member of the practice who has access to your medical records).

Arrangements for all other NHS charges remain unchanged.

Any renal dialysis patient who has a permanent fistula (permanent means lasting indefinitely) that requires an appliance or surgical dressing, is entitled to medical exemption if they have completed application form FP92A and a doctor has signed the form to confirm the condition. Whether or not you have a permanent fistula that requires an appliance or surgical dressing is a matter for your doctor's clinical judgement.

The criteria are met where there is a clinical need for a permanent fistula to be covered by a surgical dressing (for example between haemodialysis treatments) or by an appliance (such as a catheter for peritoneal dialysis).

If you are on a low income you may be eligible to receive financial help through the NHS Low Income Scheme. To apply for an HC2 certificate, you should complete form HC1, which is available from Jobcentre Plus offices or most NHS hospitals. Your doctor, dentist or optician may be able to give you one, too. You can also get an HC1 form by calling 0845 610 1112.

Whether you qualify for help is based on a comparison between your weekly income and assessed requirements at the time the claim is made. For more information about requirements visit NHS: help with health costs.

You will qualify for a full help HC2 certificate (which includes free NHS prescriptions) if your income is less than or equal to your requirements, or your income is greater than your requirements by no more than half the current English prescription charge.

You will qualify for a limited help HC3 certificate if your income is greater than your requirements by more than half the current English prescription charge. The HC3 certificate shows how much you have to pay towards your health costs.

Certificates are usually valid for periods of between six months and five years, depending on your circumstances.

Find out more about the NHS Low Income Scheme (LIS).

If you are not entitled to free prescriptions and you think you will have to pay for four or more prescriptions in three months, or 15 or more items in 12 months, you may find it cheaper to buy a prescription prepayment certificate (PPC).

You can only use the PPC for your own NHS prescriptions. The PPC will start from the date of your application or phone call unless you request a different start date. You can request a start date of up to one month earlier or one month later than the date of your application or phone call.

Details of the current prescription charges and prepayment certificate costs are available in leaflet HC12: charges and optical voucher values (PDF, 95 kb).

You can choose to pay for a 12 month PPC in a lump sum or by 10 monthly direct debit instalments. If you pay by direct debit you are entering into a commitment to pay all the instalments.

You can order a PPC online, by phoning 0845 850 0030 or by filling in an FP95 form. An FP95 form is available from some pharmacies and GP surgeries.

Remember to apply for a new PPC in good time. If you don't you will have to pay prescription charges when your old PPC runs out.

If you have to pay a prescription charge while you are waiting for your PPC, you can't get a refund unless you have an NHS receipt. The NHS receipt form is an FP57. The pharmacist or dispensing doctor can only issue an FP57 at the time you pay a prescription charge. They can't give you one later. You can claim for the refund of prescription charges up to three months after paying. The FP57 form tells you what to do.

Ask your pharmacist, hospital or doctor for an NHS receipt form FP57 when you pay for your prescription. You can't get one later. You have to apply for a refund within three months of paying the prescription charge.

If you have paid for a prescription prepayment certificate (PPC) and have become exempt from paying for prescriptions, you may be able to get some or all of the money back for your PPC.

An explanation of how to claim a refund of your PPC fee can be found on the NHS Business Services Authority website or in leaflet HC11: help with health costs (PDF, 287kb). You can also obtain the leaflet from the DH publications order line on 0845 610 1112.