Money & Budgeting

NHS Costs and Exemptions UK — What's Free and What's Not

Guide to NHS costs in the UK. What's free, prescription charges, dental costs, eye tests, wigs and fabric supports, and how to claim exemptions.

By PocketWise · · 5 min read

The NHS is mostly free, but some services have charges — and many exemptions exist. Here’s what you should know.

What’s Free on the NHS

Always Free

Service Details
GP appointments Consultations and referrals
Hospital treatment Inpatient and outpatient
A&E Emergency treatment
Maternity care Pregnancy to postnatal
Mental health services NHS provision
Walk-in centres Urgent care
Vaccinations NHS programme
Contraception Family planning
STI clinics Sexual health services
Cancer treatment Diagnosis and treatment

Sometimes Charges

Service Who Pays
Prescriptions England non-exempt
Dental treatment Most adults
Eye tests Most adults
Glasses/contacts Not NHS funded
Wigs/fabric supports Most adults (England)
Travel to hospital Usually self-funded

Prescription Charges

Where Prescriptions Are Free

Country Status
Scotland All free
Wales All free
Northern Ireland All free
England Charges unless exempt

England Prescription Charges

Item Cost (2024/25)
Per item £9.90
3-month PPC £32.05
12-month PPC £111.60

Who Gets Free Prescriptions (England)

Category Exempt
Under 16 ✓
16-18 in full-time education ✓
60 and over ✓
Pregnant or baby under 1 ✓
Certain medical conditions ✓
War pensioners (for condition) ✓
On qualifying benefits ✓
HC2 certificate ✓

Qualifying Medical Conditions

Condition Exempt
Diabetes (insulin or tablets) ✓
Epilepsy ✓
Permanent fistula ✓
Addison’s disease ✓
Underactive thyroid ✓
Diabetes insipidus ✓
Myasthenia gravis ✓
Hypoparathyroidism ✓
Cancer (certain treatments) ✓

Qualifying Benefits

Benefit Exempt
Universal Credit (income criteria) ✓
Income Support ✓
Income-based JSA ✓
Income-related ESA ✓
Pension Credit Guarantee ✓
NHS Tax Credit Exemption Certificate ✓

Prepayment Certificates

When PPCs Save Money

Items/Year Cost Without PPC PPC Cost Savings
4+ in 3 months £39.60+ £32.05 £7.55+
12+ in year £118.80+ £111.60 £7.20+

How to Get a PPC

Method Details
Online nhs.uk/ppc
Phone 0300 330 1341
Post Complete FP95 form
Payment One-off or monthly direct debit

PPC Tips

Tip Why
Get 12-month Better value if 12+ items
Pay by direct debit Spread cost
Covers all family Can share if needed
Backdate 1 month Can claim recent prescriptions

NHS Dental Charges

Dental Charge Bands (England)

Band What’s Included Cost (2024/25)
Band 1 Check-up, X-rays, scale/polish £26.80
Band 2 Fillings, extractions, root canals £73.50
Band 3 Crowns, bridges, dentures £319.10
Urgent Emergency/out of hours £26.80

Free NHS Dental Treatment

Category Exempt
Under 18 ✓
Under 19 in full-time education ✓
Pregnant ✓
Had baby within 12 months ✓
NHS hospital dental patient ✓
On qualifying benefits ✓
HC2 certificate (full help) ✓
HC3 certificate (partial help) Reduced

Getting Maternity Exemption

Document MatEx certificate
Eligibility Pregnant or baby under 1
How to get From midwife or GP
What it covers Prescriptions and dental
Duration Until baby is 1

Eye Care

Free NHS Eye Tests

Category Exempt
Under 16 ✓
16-18 in full-time education ✓
60 and over ✓
Diagnosed glaucoma ✓
Over 40 with glaucoma family history ✓
Diabetic ✓
Registered blind/partially sighted ✓
On qualifying benefits ✓
HC2 certificate ✓
Complex lens voucher holder ✓

NHS Optical Vouchers

Who Qualifies Value
Under 16 Voucher for glasses
On benefits Voucher varies by prescription
HC2 holders Voucher for glasses
Complex prescriptions Higher value voucher

Voucher Values

Category Voucher Value
A (lightest prescription) £43.30
B £66.20
C (strongest) £99.10
D (complex) £244.80

Low Income Scheme (HC2/HC3)

What It Covers

With HC2 (Full Help) Free
NHS prescriptions ✓
NHS dental treatment ✓
NHS eye tests ✓
NHS glasses voucher ✓
Wigs and fabric supports ✓
Travel to hospital ✓
With HC3 (Partial Help)
Reduced charges Based on certificate

How to Apply

Step Details
1 Complete HC1 form
2 Details of income and outgoings
3 Submit to NHS Business Services Authority
4 Receive HC2 or HC3 certificate
5 Certificate valid 6-12 months

Who Typically Qualifies

Situation Likely to Qualify
No or very low income ✓
High housing costs ✓
Savings under £6,000 (single) ✓
Savings under £8,000 (couple) ✓

Hospital Travel Costs

Who Can Claim

Eligible If Exempt
On qualifying benefits ✓
HC2/HC3 certificate ✓
Receiving certain treatments ✓
War pensioner ✓

What’s Covered

Expense Refund
Public transport Bus, train fares
Mileage If driving
Parking Some hospitals
Taxi If medically necessary

How to Claim

Step Details
Get HC5 form From hospital
Complete form With receipts
Submit To hospital cashier
Payment Refund given

If You’ve Paid When Exempt

Claiming Refunds

Payment Type Claim Method
Prescription FP57 form at pharmacy
Dental Ask dentist for refund
Eye test Ask optician
General Complete HC5 form

Time Limits

Service Claim Within
Prescriptions 3 months
Dental 3 months
Optical —
Hospital travel 3 months

Summary: NHS Costs Checklist

Check Your Exemptions

Category Applies?
Age (under 16, 16-18 education, 60+) ☐
Medical condition (see list) ☐
Pregnant or baby under 1 ☐
On qualifying benefits ☐
Low income (HC2/HC3) ☐

Save Money

Action Done
Check exemption eligibility ☐
Apply for PPC if 4+ prescriptions ☐
Apply for HC2/HC3 if low income ☐
Get MatEx if pregnant ☐
Keep receipts for refunds ☐

Key Forms

Form Purpose
FP95 Apply for PPC
HC1 Apply for HC2/HC3
FP57 Prescription refund
MatEx Maternity exemption
HC5 Hospital travel claim

Contacts

Service Details
NHS Help with Health Costs 0300 330 1343
PPC purchases 0300 330 1341
HC1 applications nhs.uk/low-income

Don’t pay for NHS services if you don’t have to. Check exemptions, apply for help, and always claim refunds if you’ve paid in error. The forms are straightforward and the savings can be significant.

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Sources

  1. MoneyHelper — Everyday money