Most NHS care is free, but in England you pay set charges for prescriptions, dental treatment and some eye care. A prescription is £9.90 per item, NHS dental care is charged in three bands from £27.90 to £332.10, and eye tests are free for many groups. Many people are exempt from all of these. This guide breaks down what you pay, what is free, and how to pay less.
Prescription charges
In England, a prescription costs £9.90 per item in 2026/27, whatever the medicine. The charge has been frozen at that level for the year. It is a charge per item, not per prescription form, so a form with three medicines on it costs £29.70.
Prescriptions are free for everyone in Scotland, Wales and Northern Ireland. The charge only applies in England. If you move from Manchester to Cardiff, your prescriptions become free. A small number of items are free everywhere, including contraception and medicines given to hospital inpatients.
Who does not pay for prescriptions
Around nine in ten prescriptions in England are dispensed free, because the exempt groups are large. You pay nothing if any of these apply to you:
| If you are | What you need |
|---|---|
| Aged 60 or over | Nothing. Automatic |
| Under 16 | Nothing. Automatic |
| Aged 16, 17 or 18 in full-time education | You may be asked for proof of your course |
| Pregnant, or gave birth in the last 12 months | Maternity exemption certificate (MatEx), applied for through your midwife or GP |
| Treated for a listed medical condition | Medical exemption certificate (MedEx), applied for through your GP |
| On a low income | HC2 certificate through the NHS Low Income Scheme |
The medical exemption list is specific rather than general. It includes treatment for cancer, a permanent fistula, epilepsy needing continuous anticonvulsive therapy, and diabetes that is treated with medication. Diabetes controlled by diet alone does not qualify. Having a long-term condition does not by itself make your prescriptions free, and the certificate has to be applied for and renewed.
One distinction catches people out: an HC2 certificate gives full help and free prescriptions. An HC3 certificate gives partial help towards costs and does not make prescriptions free.
Do not tick the box unless you are sure
Every prescription form asks you to declare why you are exempt. If you tick a box you are not entitled to, the NHS Business Services Authority can issue a penalty charge of five times the amount owed, up to £100, on top of the original charge. This is checked after the fact, so a wrong tick in January can produce a letter in June. If you are not certain you are exempt, pay the £9.90 and check afterwards.
Save with a prepayment certificate
If you pay for regular prescriptions, a Prescription Prepayment Certificate (PPC) caps your cost. You pay a fixed amount and everything you are prescribed in that period is covered, however many items you need.
| Certificate | Cost | Worth it if |
|---|---|---|
| 3-month PPC | £32.05 | You need more than 3 items in 3 months |
| 12-month PPC | £114.50 | You need more than 11 items a year |
| HRT PPC | £19.80 | You are prescribed HRT. Covers 12 months |
The 12-month PPC can be paid by Direct Debit at £11.45 a month over 10 months, which spreads the cost. The HRT PPC is separate and covers listed hormone replacement therapy items for a year, which is well below what 12 months of individual charges would come to.
NHS dental charges
NHS dental treatment in England is charged in three bands. You pay a single fixed fee based on the most complex treatment you need during a course of care, not per procedure, and not per visit. If a course takes four appointments, you still pay one band charge. From April 2026 the bands are:
| Band | Cost | Covers |
|---|---|---|
| Band 1 | £27.90 | Check-up, X-rays, scale and polish, fluoride varnish |
| Band 2 | £76.60 | Everything in Band 1 plus fillings, extractions, root canal |
| Band 3 | £332.10 | Everything in Band 2 plus crowns, bridges, dentures |
NHS dental care is free for under-18s, under-19s in full-time education, pregnant women and women who gave birth in the last 12 months, and people on qualifying benefits. The same penalty rules apply to dental claims as to prescriptions.
The practical difficulty is not the price but the supply. Many NHS practices are not taking new adult patients, and there is no waiting list you can join centrally. Search for practices taking NHS patients as soon as you arrive rather than when you have toothache, and ask to be told when they reopen their list. A practice can treat you privately and on the NHS at different times, so check which basis you are being seen on before treatment starts.
Eye tests and glasses
A private eye test costs roughly £22.50 to £25, but NHS-funded sight tests are free for large groups, including:
- Children under 16, and 16 to 18 year-olds in full-time education
- People aged 60 and over
- People diagnosed with diabetes or glaucoma
- Close relatives aged 40 or over of someone with glaucoma
- People on qualifying benefits or named on an HC2 certificate
Eligible people can also get an optical voucher towards the cost of glasses or contact lenses. The voucher covers a set amount rather than the full price, so you can still pay a top-up for frames you choose. Sight tests are free for everyone in Scotland.
Frequently asked questions
How much is an NHS prescription in 2026?
£9.90 per item in England, frozen for 2026/27. It is free in Scotland, Wales and Northern Ireland, and free for many exempt groups in England.
How much does an NHS dentist cost?
You pay one band fee per course of treatment: £27.90 (Band 1), £76.60 (Band 2) or £332.10 (Band 3) from April 2026, however many appointments the course takes.
Is a GP appointment free?
Yes. Seeing your GP and hospital treatment are free. The charges here apply only to prescriptions, dental and some eye care.
How can I pay less for regular prescriptions?
Buy a Prescription Prepayment Certificate. At £114.50 a year, or £11.45 a month by Direct Debit, it caps your cost no matter how many items you need.
What happens if I claim a free prescription by mistake?
The NHS Business Services Authority can charge you five times the amount owed, up to £100, plus the original charge. If you are unsure whether you qualify, pay and check afterwards.
Does a long-term condition make my prescriptions free?
Not automatically. Only listed conditions qualify, and you need a medical exemption certificate applied for through your GP. Diet-controlled diabetes, for example, does not qualify.
For how healthcare fits together, see the NHS guide for newcomers.
