Help with NHS Costs

Some people are entitled to help with healthcare costs, such as the cost of prescriptions, dental treatment, eye tests, glasses and contact lenses, wigs and fabric supports, or travel to and from hospital.

You are entitled to help with paying for healthcare costs if you:

• are aged 16 or under,
• are aged 16, 17, or 18, and in full-time education,
• are aged 60 or over,
• are pregnant, or have had a baby in the last 12 months, or
• are receiving Income Support, Income-based Jobseeker’s Allowance, or Pension Credit Guarantee Credit,
• have an NHS Tax Credit Exemption Certificate, or
• have a certain specified medical condition, such as cancer, epilepsy or diabetes, and have a valid NHS Medical Exemption Certificate.

Over the counter can be cheaper

Some commonly prescribed medications, including painkillers, allergy tablets and dermatology creams, are also available over the counter without prescription. Often it’s much cheaper just to buy them this way, rather than paying the £8.80 flat prescription charge.

Some pharmacies, including all Boots stores, have policies to always tell you if you’re better off doing it this way.

Medical Exemption Certificates

People with specified medical conditions can get free NHS prescriptions if:

• they suffer from any of the medical conditions listed below and
• they hold a valid Medical Exemption Certificate

The Authority’s Medical Exemption Issue Office is responsible for issuing Medical Exemption Certificates on behalf of the Department of Health for England to patients who suffer from one of the specified medical conditions.

The specified medical conditions are:

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

To apply for an NHS Medical Exemption Certificate, ask at reception.

If you are on a low income and are having difficulties paying NHS charges, you may be able to qualify for additional help through the NHS Low Income Scheme. Ask for a HC1 form from your GP surgery, dentist or opticians. Alternatively, you can call their helpline on 0845 850 1166. Calls are charged at the local rate.

Prescription Prepayment Certificate (PPC)

Anyone who regularly pays for prescriptions should consider buying a prescription pre-payment certificate (season-ticket), which covers all your NHS prescription fees for a set period.

The short three months certificate costs £29.10 and is cheaper if you use 4 or more prescriptions in that time. The 12 months certificate is £104 and will be cheaper if you use 13 or more prescriptions.

As a rule of thumb, if you are paying for more than one prescription a month and you will save with a season-ticket.

If your condition is long-term, the 12 months certificate is the better value of the two. Someone getting two prescriptions a month over a year would save £89.

How to get a certificate

The easiest way to get a certificate is on the NHS Prescription Pricing Authority website, and you can pay by credit card or direct debit to spread the cost. Forms are also available in main Post Offices and some pharmacies. Alternatively, call 0845 850 0030.

Do note if you become eligible for free prescriptions after buying a certificate, you can reclaim the proportional cost for that time.

Back date it up to three months

Normally certificates start on the day applications are received, however you can request it counts as starting up to three months earlier, a big saving if you’ve just laid out for a bulk of prescriptions. You must ask for an NHS receipt (FP57) from the pharmacist at the time when you buy the prescriptions that you want to claim back. They can’t give you one later.

You can only buy a PPC for your own prescriptions, and not on behalf of someone else. Your pharmacist will be able to give you an application form for a PPC.

More information about who is eligible for help with healthcare costs, and which costs are covered, can be found in the leaflet ‘Help with health costs’, published by the Department of Health. See the ‘further information’ section for more details.