Knowing the rules can save you hundreds on prescription costs.
⚡ Quick Answer
The NHS prescription charge in England for 2026/27 stays at £9.90 per item — frozen for a second year. A Prescription Prepayment Certificate (PPC) pays for itself if you pick up more than 3 items in 3 months, or more than 11 in a year. Over-60s, under-16s, and people on certain benefits get free prescriptions automatically. And from 15 April 2026, new Income Support and Income-based JSA claimants lose their automatic exemption.
If you’re picking up regular prescriptions, you’ll have felt the charge. For 2026/27, the good news is it’s not going up. The Chancellor confirmed a second consecutive freeze at £9.90 per item — a move that’s expected to save English patients roughly £12 million over the coming year, per the GOV.UK announcement.
This guide lays out the whole picture in 2026: exactly what you’ll pay, when a prepayment certificate earns its keep, who qualifies for free prescriptions automatically, and the one important rule change this April that a lot of claimants haven’t seen coming.
The 2026/27 prescription charges — frozen at £9.90 per item
The headline figure for 2026/27 is stability. The single prescription item charge in England is £9.90 — same as 2025/26, and unchanged since April 2025. It’s the second consecutive freeze, and the Treasury confirmed it in early 2026. Per the GOV.UK announcement, the freeze will save patients collectively around £12 million over the year compared to an inflation-linked increase.
Practically, that means the bill doesn’t grow for people managing multiple items a month. £9.90 an item is still meaningful, especially if you’re on four or five regular medicines — blood pressure tablets, a statin, an inhaler, perhaps an antidepressant — but at least for another year, the per-item price isn’t climbing. The saving is a direct acknowledgement of the pressure on household budgets, particularly for people with long-term conditions who can’t just skip a month.
The prepayment certificate maths — when a PPC saves you money
This is where five minutes of arithmetic could save you several hundred pounds. A Prescription Prepayment Certificate (PPC) is a season ticket for NHS prescriptions: flat fee, unlimited items for the duration. The 2026/27 prices are shown below.
A worked example: Say you’re on four regular items, collected once a month. That’s 48 items a year at £9.90 = £475.20. Buying an annual PPC at £114.50 saves you £360.70. For two regular items a month, you’d pay £237.60 annually — still more than the PPC, so you’d save £123.10. For one regular item a month, you’d only be paying £118.80, which is so close to the PPC that it’s roughly a wash. Under that, there’s no point.
You can buy a PPC online at nhsbsa.nhs.uk/ppc, by phone through the NHSBSA, or at selected pharmacies. For the 12-month certificate, you can spread the cost by direct debit over 10 monthly instalments (about £11.45 a month), which makes the upfront impact easier if you’re budgeting week-to-week.
Always check if you qualify for an exemption before paying.
Who gets free prescriptions automatically — the big groups
You may not need to pay at all. The exemption categories are wider than most people realise. Per NHSBSA figures, around 89% of all prescriptions dispensed in England are already free.
The main automatic groups: age-based (under 16, 16-18 in full-time education, 60+), maternity (pregnant or under-12-months post-birth via the FW8 form), income-based (Universal Credit meeting thresholds, income-related ESA, Working Tax Credit / Child Tax Credit when income-tested), NHS inpatients during admission, HC2 Low Income Scheme holders, and War Pension recipients for accepted disablement.
Over-60s don’t need a certificate — just tick the age box on the back of the prescription when you collect it. If you’re on a low income or any benefit, check the rules before you pay.
The Medical Exemption Certificate — conditions that qualify
If you have one of a specific list of long-term medical conditions, you can apply for a Medical Exemption Certificate (MedEx). That gets you free NHS prescriptions for five years, regardless of your income or age.
📋 Qualifying Conditions
- Permanent fistula needing continuous dressing or appliance (caecostomy, colostomy, laryngostomy, ileostomy)
- Hypoadrenalism requiring substitution therapy (Addison’s Disease is the classic example)
- Diabetes insipidus and other forms of hypopituitarism
- Diabetes mellitus — EXCEPT where treatment is by diet alone (insulin or tablet-treated qualifies)
- Myxoedema (hypothyroidism on thyroid hormone replacement)
- Epilepsy requiring continuous anticonvulsive therapy
- A continuing physical disability that stops you going out without the help of another person
- Any form of cancer, including effects of treatment (rule since April 2009)
Application process: your GP provides an FP92A form, you send it to NHSBSA, certificate arrives by post within 10 working days, backdated to 1 month before application receipt. Valid 5 years, then renew.
What changed on 15 April 2026 — the Income Support and JSA cliff-edge
⚠️ Rule change 2026
New Income Support and JSA claims no longer auto-exempt
One important change this spring. From 15 April 2026, people making a NEW claim for Income Support or income-based Jobseeker’s Allowance no longer automatically qualify for free NHS prescriptions. The route via those benefits has been closed for new claimants.
This doesn’t affect existing claimants — if you already had an exemption certificate through one of those benefits, it remains valid until renewal. But for anyone applying for Income Support or income-based JSA from mid-April 2026 onwards, the automatic prescription exemption isn’t part of the package any more. The alternative routes are the NHS Low Income Scheme or — for those who qualify — the Universal Credit exemption route.
The HRT PPC — why this one’s a genuine bargain
The HRT Prescription Prepayment Certificate is £19.80 a year for unlimited HRT-related prescription items — 12 months. It’s a separate certificate from the standard PPC, and you can hold both in parallel.
Who benefits most? Women in perimenopause or menopause on combined HRT regimens — typically an oestrogen (gel, patch, or tablet) plus a progestogen (tablet or coil), and sometimes testosterone. That’s two or three items per prescription cycle. Without the HRT PPC, two items collected every three months is about £80 a year. With the HRT PPC, it’s under £20. If you’re on HRT and you don’t have the certificate, it’s almost always the right move.
NHS Low Income Scheme — the HC2 and HC3 routes most people miss
If you don’t fit any automatic category but are finding NHS costs a strain, this is the safety net. The Low Income Scheme covers help with prescriptions, dental treatment, sight tests, wigs, and hospital travel costs.
You apply with an HC1 form — available from Jobcentre Plus offices, NHS hospitals, some pharmacies, and online. Qualify and you’re sent an HC2 certificate (full help — everything free) or an HC3 certificate (partial help, with a capped contribution). The thresholds depend on household size, income, savings, and circumstances — not a fixed headline number — but the scheme is aimed at people on a modest income who fall outside the benefits system. If you’re self-employed on a low trading income, a carer, or on a single wage supporting adults at home, an HC1 form is worth the hour.
Five practical questions to ask yourself before 31 December 2026
A five-minute health-cost MOT. Run through these:
More than 11 and an annual PPC saves money. More than 3 in three months and a 3-month PPC pays for itself.
Double-check age, benefit status, parental status, education status for teenagers.
Insulin-treated diabetes, epilepsy, a permanent fistula, hypothyroidism on replacement, any cancer — ask your GP for FP92A today.
£19.80 HRT PPC is a no-brainer.
Send the HC1 form off. Worst case nothing; best case an HC2 certificate.
Frequently Asked Questions
How much is an NHS prescription in 2026?
The NHS prescription charge in England for the 2026/27 financial year is £9.90 per item. It’s been frozen at this level for the second consecutive year by the Chancellor, which GOV.UK estimates will save English patients around £12 million compared to an inflation-linked rise.
How much does the annual PPC cost in 2026/27?
The 12-month Prescription Prepayment Certificate costs £114.50 in 2026/27. It covers unlimited NHS prescription items for the year and pays for itself if you need more than 11 items in that period. You can spread the cost over 10 monthly direct-debit payments of about £11.45.
Which medical conditions qualify for a free NHS prescription?
You can apply for a Medical Exemption Certificate if you have insulin-treated or medication-treated diabetes (not diet-alone), epilepsy requiring continuous anticonvulsive therapy, a permanent fistula, hypoadrenalism (e.g. Addison’s), myxoedema on thyroid replacement, any form of cancer including treatment effects, or a continuing physical disability that prevents you going out unaided.
Do over-60s still get free prescriptions in 2026?
Yes. Adults aged 60 or over in England automatically qualify for free NHS prescriptions. No certificate is needed — simply tick the age-related exemption box on the back of the prescription form when you collect it. The exemption is automatic and doesn’t change in 2026/27.
What’s changing about Income Support and NHS prescriptions in April 2026?
From 15 April 2026, people making a new claim for Income Support or income-based Jobseeker’s Allowance will no longer automatically qualify for free NHS prescriptions. Existing claimants keep their exemption until renewal. New claimants need to use the NHS Low Income Scheme or the Universal Credit route instead.
⭐ The Bottom Line
Don’t pay £9.90 at all if you don’t have to.
If you’re picking up more than a couple of regular prescription items, spending an hour on this is one of the most effective bits of household financial admin you can do. Count your items, check whether you’re in an automatic exemption category, look at the MedEx list with a particular condition in mind, and if you’re anywhere near the income line, send off the HC1.
With charges frozen at £9.90 a year, the goal is simple: either don’t pay at all if you don’t have to, or cap your costs with a certificate if you do. The system looks complex because the rules are old and layered — but the rules themselves are there to be used.
Related reading: NHSBSA help with NHS prescription costs · GOV.UK get a PPC
Published: 24 April 2026 · Last updated: 24 April 2026
