An NHS prescription in England costs £9.90 per item in 2026/27. A prepayment certificate covers any number of items for £32.05 over three months or £114.50 over twelve, so anyone collecting more than one item a month saves money with the annual certificate, and a three-month certificate pays for itself at four items. Around nine in ten prescriptions are dispensed free, because children, people over 60, pregnant women, those with listed medical conditions and people on low incomes or certain benefits are exempt. Prescriptions are free for everyone in Scotland, Wales and Northern Ireland.
The charges
| 2026/27 | |
|---|---|
| Charge per prescription item, England | £9.90 |
| Three-month prepayment certificate | £32.05 |
| Twelve-month prepayment certificate | £114.50, or ten monthly direct debit payments of £11.45 |
| HRT prepayment certificate, twelve months | £19.80 |
The charge is per item, not per prescription form, so a form listing three medicines costs £29.70. The same charge applies to a 28-day supply and a three-month supply, which is why asking a GP for longer prescriptions of a stable medicine reduces the cost. The HRT certificate covers listed hormone replacement therapy items only, for a year, at the price of two ordinary items.
When a prepayment certificate pays off
| Items a month | Cost at £9.90 an item over a year | Twelve-month certificate | Saving |
|---|---|---|---|
| 1 | £118.80 | £114.50 | £4.30 |
| 2 | £237.60 | £114.50 | £123.10 |
| 3 | £356.40 | £114.50 | £241.90 |
| 4 | £475.20 | £114.50 | £360.70 |
The twelve-month certificate breaks even at twelve items in a year and the three-month certificate at four items in three months. Someone on two regular medicines who expects to need them for the foreseeable future saves £123 a year; on four medicines the saving is £360. The certificate can be bought online or at a pharmacy and starts from any date, and a refund is available if the holder later qualifies for free prescriptions. The prepayment certificate calculator works the saving for your own number of items and shows which certificate to buy.
Who pays nothing
| Exemption | Proof |
|---|---|
| Under 16, or 16 to 18 in full-time education | Age or education status declared on the form |
| Aged 60 or over | Age |
| Pregnant, or a baby in the last twelve months | Maternity exemption certificate |
| Listed medical condition | Medical exemption certificate |
| War pension, for the accepted disablement | War pension exemption certificate |
| Income Support, income-based JSA, income-related ESA or Pension Credit Guarantee Credit | Benefit award |
| Universal Credit with earnings of £435 or less in the last assessment period, or £935 with a child element or limited capability for work | Universal Credit award |
| Low income | HC2 certificate from the NHS Low Income Scheme |
The medical exemption list covers diabetes other than diet-controlled, epilepsy needing continuous medication, hypothyroidism, cancer treatment and its effects, a permanent fistula, certain adrenal and pituitary conditions and a continuing physical disability that prevents going out without help. Other long-term conditions such as asthma and high blood pressure are not on the list, and people with them pay unless another exemption applies. The free prescriptions checker runs through the exemptions, and the NHS Low Income Scheme calculator estimates whether an HC2 certificate for full help or an HC3 for partial help is likely on your income and savings.
Universal Credit and the earnings test
The Universal Credit exemption depends on the household’s earnings in the most recent assessment period, not on the award itself: £435 or less, or £935 or less where the award includes a child element or a limited capability for work element. Earnings just above the line remove free prescriptions, dental treatment and sight tests together, which is worth checking before taking on extra hours; the NHS Low Income Scheme may still give partial help. Our Universal Credit rates guide covers the elements themselves.
Dental charges and sight tests
| NHS dental band, England | Charge | Covers |
|---|---|---|
| Band 1 | £27.90 | Examination, diagnosis, advice, scale and polish where clinically needed |
| Band 2 | £76.60 | Band 1 plus fillings, root canal treatment and extractions |
| Band 3 | £332.10 | Bands 1 and 2 plus crowns, dentures and bridges |
| Urgent treatment | £27.90 | Emergency care in one visit |
Dental treatment is free for under 18s, 18-year-olds in full-time education, pregnant women and mothers of babies under one, and people receiving the qualifying benefits above or holding an HC2 certificate. NHS sight tests are free for the same benefit groups and for everyone over 60, under 16, aged 16 to 18 in education, or with diabetes or glaucoma, and vouchers towards glasses go with the benefit exemptions. The NHS dental cost calculator shows the band and the charge for a course of treatment.
Common questions
How much is an NHS prescription in 2026/27? £9.90 per item in England. Prescriptions are free in Scotland, Wales and Northern Ireland.
How much is a prepayment certificate? £32.05 for three months or £114.50 for twelve, which can be paid in ten monthly instalments of £11.45. The HRT-only certificate is £19.80 a year.
When is a prepayment certificate worth it? From twelve items a year for the annual certificate, or four items in three months for the quarterly one. Two items a month saves £123 a year.
Who gets free prescriptions? Under 16s, 16 to 18 year olds in education, everyone aged 60 or over, pregnant women and new mothers, people with a medical exemption certificate, war pensioners for their condition, and people on qualifying benefits or with an HC2 certificate.
Are prescriptions free on Universal Credit? Only where earnings in the last assessment period were £435 or less, or £935 or less with a child element or limited capability for work.
How much is an NHS dental check-up? £27.90 for a Band 1 course of treatment in England, £76.60 for Band 2 and £332.10 for Band 3.
Information, not medical or financial advice. Charges are the published 2026/27 figures on nhs.uk: NHS prescription charges and nhs.uk: NHS dental charges; the exemption rules are those of the NHS Business Services Authority. Check your own entitlement before claiming free treatment, as incorrect claims carry a penalty charge.