Who is entitled to get free prescriptions in England?
- If you are aged 60 or over.
- If you are aged under 16.
- If you are aged 16, 17 or 18 and in full-time education.
- If you are pregnant, or have had a baby in the previous 12 months, and have an exemption certificate (see below).
- If you have a listed medical condition and have an exemption certificate (see below).
- If you are an NHS inpatient.
- If you (or your partner) gets one of the following:
- Income Support.
- Income-based Jobseeker's Allowance.
- Income-related Employment and Support Allowance.
- Pension Credit Guarantee Credit.
- If you are entitled to, or named on, a valid NHS tax credit exemption certificate.
- Some war pensioners - if treatment is connected with the pensionable disability.
- People on a low income who have a certificate HC2 (see below).
If you are entitled to free prescriptions, complete the declaration on the back of the prescription and sign it. You may be asked for proof that you are exempt.
Who can get an exemption certificate?
If you are pregnant or have had a child in the past year
You need to apply for a Maternity Exemption Card, using form FW8. The form is available from doctors, nurses, midwives and health visitors. You are required to complete the form and your doctor, nurse, midwife or health visitor will sign the form to confirm the information given by you is correct.
The card will last until 12 months after the expected date of the birth (you can apply for an extension if the baby is born late). If you have a Maternity Exemption Card all your prescriptions are free, whatever the medication is for.
People who have certain medical conditions
Although there are many conditions requiring regular medication, only the following qualify for an exemption certificate:
- Treatment for cancer; note this includes treatment for the effects of cancer, or treatment for the effects of a current or previous cancer treatment.
- A permanent fistula requiring dressing.
- Forms of hypoadrenalism such as Addison's disease.
- Diabetes insipidus and other forms of hypopituitarism.
- Diabetes mellitus except where treatment is by diet alone.
- Myxoedema (underactive thyroid) or other conditions where thyroid hormone replacement is necessary.
- Myasthenia gravis.
- Epilepsy requiring continuous anticonvulsive medication.
- A continuing physical disability which means you cannot go out without help from another person.
If you have one of the specified conditions ask for an application form (FP92A - clearly marked 1 January 2009) from your doctor's surgery. You need to fill it in and your doctor (or an authorised member of the practice staff) will sign to confirm the information you've given is correct. You will then be sent a Medical Exemption Certificate.
If you have a Medical Exemption Certificate all your prescriptions are free, whatever the medication is for.
How can people on a low income apply for help?
Some people on a low income may qualify for help with prescription charges. Your entitlement to help is based on your circumstances, such as your level of income, savings, etc. You will have to fill in an HC1 form 'Claim for Help with Health Costs' giving various details of your circumstances and then send it off in the prepaid envelope provided.
If you qualify for help, you will be sent an HC2 Certificate for full help, or an HC3 Certificate for partial help, which you will need to produce when paying for your prescription. The certificate will tell you whom it covers and how long it lasts. If your circumstances change for the better, you can continue using the certificate until it expires. If your circumstances change for the worse during the period of the certificate, you should make another claim. If your circumstances will remain unchanged after the time period, then make a new claim before the current certificate expires.
How can I get the HC1 claim form?
You should be able to get the claim form from:
- Your JobCentre Plus office.
- An NHS hospital.
- By phoning the NHS Formsline on 0845 610 1112, textphone: 08700 102 870.
- By phoning the Department of Health Publications Orderline on 0845 610 1112, textphone number 08700 102 870.
- Your dentist or optometrist (optician), who may stock them.
Can I claim a refund for a prescription charge I have already paid?
If you are on a low income, but have not yet got your exemption certificate, then get a receipt form from the pharmacist when your prescription is dispensed. Note that you cannot get one later. When you get your exemption certificate, send the receipt form to the address on the form to get a refund.
How can regular prescription charges be reduced?
If you do not qualify for exemption you may be able to reduce the cost of your prescriptions by buying a Prescription Prepayment Certificate ('season ticket'). This certificate will cover the cost of all your prescriptions during a particular period.
For example, if you pay for more than 3 prescription items in 3 months, or more than 13 items in 12 months, you could save money by buying a Prescription Prepayment Certificate. As at 1 April 2012 the charge for a single prescription item is £7.65.
A Prescription Prepayment Certificate costs £29.10 for 3 months and £104.00 for 12 months.
You can apply for a Prescription Prepayment Certificate:
- by completing form FP95 which you can get from pharmacies and doctors surgeries OR
- online at www.nhsbsa.nhs.uk/1127.aspx OR
- by telephone - 0845 850 0030 - have ready a credit or debit card.
If you pay a prescription charge whilst waiting for a Prescription Prepayment Certificate to be issued, you can get a refund. To do this you must get a receipt form from the pharmacist (FP57). You must get the receipt form when you pay for your prescription; you cannot get one later. Fill the receipt form in and send it off to claim the refund.
You have to apply for a refund within three months of paying the prescription charge.
How can I find out more about help with prescription charges?
This leaflet only gives a brief summary of how to obtain free or reduced cost prescriptions and is for guidance only. It does not cover all situations and it is not a full statement of the law. The official information booklet 'Help with health costs' (HC11) provides more details for people on a low income. Your local Jobcentre Plus office, NHS hospital, pharmacist, doctor, dentist or optician may have a leaflet on help with health costs and relevant claim forms. The booklet is available as a download from: www.nhsbsa.nhs.uk/HealthCosts/1558.aspx
Information from Directgov.
Information from the Department of Health.
Benefit Enquiry Line (BEL)
Tel: 0800 88 22 00 Textphone: 0800 24 33 55 For people with disabilities, their carers and representatives. It is part of the Department for Work and Pensions. BEL offers confidential advice and information on benefits and how to claim them. In addition, they can also send out an extensive range of leaflets and claim packs, and help you to complete a claim form over the phone.
Citizens Advice Bureau
Also listed in the phone book under 'Citizens Advice Bureaux', provides independent advice on many issues including benefits.
|Original Author: Dr Tim Kenny||Current Version: Hilary Cole||Peer Reviewer: Ros Jones|
|Last Checked: 14/06/2012||Document ID: 4482 Version: 49||© EMIS|
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.