Do I have to pay for prescriptions if I’m disabled?

Are prescriptions free if I am disabled?

NHS prescription charges are £9.90 per item and if you are disabled or have a health condition, medication costs can end up being expensive. So it is worth finding out if your disability makes you eligible for free prescriptions.

If you live in England, you have to pay for your prescriptions unless you are exempt. Prescribed medication is free if you live in Scotland, Wales or Northern Ireland.

Who can get free prescriptions in England?

You are automatically exempt, regardless of your disability, if:

• You are aged 60 or over
• You are aged 16 or under
• You are aged 17, 18 or 19 and in full-time education

You may be exempt if you receive one of the following benefits:

• The Guarantee Credit part of Pension Credit
• Universal Credit, if your earnings are below a certain amount
• Income Support
• Income-based Jobseeker’s Allowance
• Income-related Employment and Support Allowance

If you do receive one of these benefits, it’s important that you are the named claimant.

If you get Child Tax Credit, or Working Child Tax Credit including the disability element, and your income is below a certain amount, you will automatically receive an NHS Tax Credit Exemption Certificate, which entitles you to free prescriptions.

Other certificates that entitle you to free prescriptions include:

• HS2 Certificate (part of the NHS Low Income Scheme)
• War Pension Exemption Certificate (if you get a War Pension and need medication for the condition you were awarded it for)
• NHS Maternity Exemption Certificate (if you’re currently pregnant or have given birth in the last 12 months, including if the baby was stillborn)

Does my disability qualify me for free prescriptions?

If you do not meet any of the above criteria but you do have a disability, you might be eligible for a medical exemption certificate, also called a MEDEX. This certificate entitles certain disabled people to free prescriptions.

If you have a physical disability that means you cannot go out without support, you should be eligible for a MEDEX. This must be an ongoing disability that you live with for a long time and the support should be from another person, rather than a guide dog or special equipment.

Examples of eligibility for free prescriptions for disabled people include:

• You have Multiple Sclerosis and cannot get out and about without someone to operate your wheelchair and support you with eating, drinking and going to the toilet
• You are registered blind and cannot use a guide dog or cane alone safely
• You have very frequent seizures and need someone with you at all times when out
• You have severe arthritis that makes walking, driving, shopping, eating and drinking very painful so someone always assists you

A learning disability is not listed as an eligible criterion, even if you cannot go out alone due to your learning disability.

Other eligible medical conditions include:

• Cancer that you are still in some form of treatment for
• Epilepsy for which you need continuous anticonvulsive therapy
• A permanent fistula that needs continuous care
• Hypoparathyroidism
• Myasthenia gravis
• Myxoedema
• A form of hypoadrenalism
• A form of hypopituitarism
• Diabetes mellitus which you require medication for, rather than it being treatable through dietary changes

Medical exemption certificate (MEDEX)

To apply for a MEDEX so you can get free prescriptions for disability, speak to your GP who will fill in an FP92A application form for you. They will then send it to the NHS Business Service Authority (NHSBSA) and you should receive your certificate within two weeks.

If you live elsewhere in the UK but will be staying in England and would like to apply for a MEDEX, you can see your local GP and the process is much the same, but they fill in a different form.

These are:
England – FP92A form
Scotland – EC92A form
Wales – FP92W form
Northern Ireland – HC11B form

A medical exemption certificate is valid for five years. If you present an invalid or out of date certificate, you won’t be eligible to have your prescription paid for by the NHS.

You can renew your certificate by asking your GP to do so. You will get a letter shortly before it expires to remind you to speak to the GP about getting a new one. 

Refunds on previous prescriptions if I am exempt

If you have been paying for your prescriptions without realising that you have a disability that makes you eligible for free prescriptions, you may be able to get a refund. These are only available in England as only England charges for prescribed medicines.

To apply for a refund, ask your pharmacist or dispensary (wherever you collect your prescription medication from) for an FP57 form.

You must apply within three months of the payment you want a refund for. You cannot get a refund directly from your pharmacist for any further back than that. For older refunds, you can write to the NHSBSA at the address below, providing your evidence and explaining why you did not claim your refund within three months of payment(s).

The pharmacist can process your FP57 form for you. They will ask some questions and will need to see your evidence that you are now exempt, such as a MEDEX certificate or your ID to show you’re now over 60.

There are tight procedures around this to avoid fraud, so if your pharmacist is unable to give you an FP57 form, you can contact the NHSBSA.

Online form: Contact Us  · Customer Self-Service

Post:

NHSBSA
Help with Health Costs
Bridge House
152 Pilgrim Street
Newcastle upon Tyne
NE1 6SN

Telephone: 0300 330 9291
Textphone: 18001 0300 330 929