Help with prescription medicines on a low income

When you live on a small income, a repeat prescription can force a choice between medicine and food or heating. Going without is more common than many people think, particularly among working adults on low pay in England, who are not automatically exempt from charges. Skipping doses, splitting tablets or leaving a prescription at the pharmacy can make a condition worse and lead to more time off work.

The good news is that prescriptions are already free in most of the United Kingdom, and in England many people on low incomes qualify for free prescriptions or can cap their costs. This page explains the rules nation by nation, how to check your entitlement, how to cut costs if you must pay, what to do about over-the-counter medicines, and why borrowing for medicines should be avoided. For wider health costs such as hospital travel, see our page on help with medical expenses.

Where prescriptions are free

NHS prescriptions are free for everyone in Scotland, Wales and Northern Ireland when issued and dispensed within that nation's NHS. If you live there, you should not be paying for NHS prescriptions at a local pharmacy. In England, a flat charge applies to each item unless you are exempt. The amount is set by the government and reviewed regularly, so check the current figure on the NHS website or with your pharmacist rather than relying on an old leaflet.

Who gets free prescriptions in England

You do not pay if, on the day the prescription is dispensed, you:

• are under 16, or aged 16 to 18 and in full-time education;
• are 60 or over;
• are pregnant or have had a baby in the last 12 months and hold a valid maternity exemption certificate;
• have a specified medical condition, such as certain forms of diabetes, epilepsy treated with medication or an under-active thyroid needing replacement treatment, and hold a medical exemption certificate;
• are being treated for cancer, or the effects of cancer or its treatment, and hold a medical exemption certificate;
• receive Income Support, income-based Jobseeker's Allowance, income-related Employment and Support Allowance or the guarantee element of Pension Credit;
• receive Universal Credit and meet the earnings conditions for your circumstances;
• hold a valid HC2 certificate, an NHS tax credit exemption certificate or a war pension exemption certificate for your accepted disability.

Use the NHS online eligibility checker before ticking a box on the back of the form, or ask the pharmacist what proof is needed. The NHS checks claims, and a wrong claim can lead to a penalty charge. Take particular care on Universal Credit: eligibility depends on your earnings in the assessment period, so it can change from one month to the next.

The NHS Low Income Scheme

If you are not on a qualifying benefit but your income is low, for example because you work part time or zero hours, are a student, live on savings or have a small pension, apply to the NHS Low Income Scheme online or with form HC1. It looks at your income, savings and housing costs.

• An HC2 certificate gives free prescriptions and full help with other NHS health costs.
• An HC3 certificate gives partial help and shows how much you are expected to contribute.

Certificates last for a fixed period, so note the expiry date and reapply in good time. If you paid while waiting for a decision, ask for a refund receipt (form FP57) at the pharmacy when you pay; you can then claim the money back once your certificate arrives.

Cutting the cost if you have to pay

Prescription prepayment certificate

If you need several items regularly, a prescription prepayment certificate covers all your NHS prescriptions for three or twelve months for a fixed price. The twelve-month version can usually be paid by monthly direct debit, which spreads the cost. Compare the price with the number of items you collect: for many people with a long-term condition, it saves a large share of the cost.

HRT prepayment certificate

England also offers a separate, cheaper annual certificate that covers listed hormone replacement therapy medicines only. Ask your pharmacist whether your medicines qualify.

Talk to your GP and pharmacist

• Ask whether a medicine is still needed, or whether a combined tablet could replace two separate items.
• Ask whether a longer supply per prescription is clinically appropriate.
• Never stop or ration a medicine without speaking to a health professional first.

Situations that are easy to miss

• Students. A student aged 19 or over is not automatically exempt in England, but a low student income often qualifies for the NHS Low Income Scheme. Apply at the start of the academic year.
• Zero-hours and part-time workers. Income that changes from month to month can move you in and out of Universal Credit earnings limits. Check each time, and consider an HC2 application if your pay is consistently low.
• Living near a border. Whether you pay depends on where the prescription is issued and dispensed, not only where you live. Ask your pharmacist if you are registered with a GP in another nation.
• Caring for someone. If you collect prescriptions for a relative, make sure their exemption is recorded correctly, and keep their certificate details to hand.

Over-the-counter medicines and minor illness

Painkillers, allergy tablets and cough remedies are not covered by prescription exemptions when you buy them in a shop. Own-brand versions usually contain the same active ingredient as branded products at a fraction of the price; the pharmacist can confirm. In England, the Pharmacy First service lets pharmacists treat some common conditions, supplying NHS medicines where needed, and if you are exempt from charges these are free. In Scotland, Wales and Northern Ireland, similar pharmacy schemes for minor ailments exist. Asking the pharmacist first can avoid both a GP wait and an unnecessary purchase.

Practical check-list

• Check whether you live in a nation where prescriptions are free.
• In England, use the NHS eligibility checker before each claim.
• Apply for a maternity or medical exemption certificate if you qualify.
• Apply to the NHS Low Income Scheme if your income is low but you are not on a qualifying benefit.
• Ask for an FP57 refund receipt if you pay while waiting for a decision.
• Compare the cost of a prepayment certificate with your monthly items.
• Check your benefits with Citizens Advice or a welfare rights adviser.
• Ask your council's crisis scheme for help if you have no money at all for an urgent item.

If medicines are only one of several bills you cannot cover this month, our page on emergency financial assistance sets out where to ask first.

Why borrowing for medicines is a poor idea

A prescription is a recurring cost. Borrowing to pay for it simply moves the problem into next month with interest added. If you cannot afford medicines, the answer is nearly always an exemption, a certificate or more income, not credit. If you are short for a few days before your next payment, ask a relative, contact your council's welfare scheme, or speak to a credit union about a small loan at capped interest, and compare the APR and total cost carefully.

Be wary of online sellers offering cheap prescription medicines without a proper consultation: they may supply fake or unsafe products. Avoid any lender that asks for a fee upfront or approaches you through social media. If your budget never stretches to essentials, free debt advice can review your whole situation; see our page on borrowing while receiving benefits for what to weigh up before any loan.