NHS Costs and Exemptions UK 2026/27 — Prescription Charges, Dental Fees and Who Pays Nothing

NHS charges explained for 2026/27: prescription charges, dental fees, who is exempt, and how a Prescription Prepayment Certificate saves money if you need regular medication.

NHS charges in 2026/27 apply to prescriptions and dental treatment in England — but a substantial portion of the population qualifies for free or reduced-cost services, and most people who do pay have not checked whether a Prepayment Certificate would reduce their costs. Understanding what you owe, what you are entitled to, and how to avoid overpaying is worth a few minutes of your time.

NHS Prescription Charges 2026/27

The standard prescription charge in England from April 2026 is £9.90 per item. Each item on a prescription is charged separately — so a prescription containing three medications costs £29.70.

Prescriptions are completely free in Scotland, Wales, and Northern Ireland. The charges below apply only to patients collecting prescriptions in England.

Item Charge (England, 2026/27)
Standard prescription charge (per item) £9.90
3-month Prepayment Certificate £31.25
12-month Prepayment Certificate £111.60

Who Is Exempt from Prescription Charges

Category Evidence required
Under 16 years old Date of birth on form
Aged 16 to 18, in full-time education Declaration on form
Aged 60 or over Date of birth on form
Medical exemption certificate (MedEx) HC5 form or FP92A
Maternity exemption certificate (MatEx) MatEx certificate
Qualifying benefit recipient HC5 form
NHS inpatient Automatic — no form needed

Conditions that qualify for a medical exemption certificate include: diabetes requiring insulin, epilepsy requiring continuous anticonvulsant therapy, hypothyroidism, hypoadrenalism (Addison’s disease), hypoparathyroidism, myasthenia gravis, permanent fistula requiring dressings, continuing physical disability preventing unaided outdoor travel, and any cancer diagnosis or its treatment effects.

If you are not sure whether you qualify, the NHS Business Services Authority provides an online checker. Incorrectly claiming exemption is a criminal offence — penalties include a charge of up to £100 plus the prescription cost.

NHS Dental Charges 2026/27

NHS dental treatment in England is charged in three bands. Once you start a course of treatment, all further treatment in that band during the same course of care is included in the band charge — so multiple fillings within one course of treatment all fall under the single Band 2 charge.

Band Charge (2026/27) Treatment covered
Band 1 £26.80 Check-up, X-rays, preventive advice, scale and polish
Band 2 £73.50 Fillings, extractions, root canal treatment
Band 3 £319.10 Crowns, dentures, bridges, advanced procedures

Dental treatment is free for: children under 18, pregnant women, and women who have given birth in the past 12 months. People receiving qualifying benefits (Universal Credit, Income Support, Pension Credit, income-related ESA or JSA) are entitled to free NHS dental treatment — apply via the HC1 form for a Health Cost Certificate (HC2).

Is the Prescription Prepayment Certificate Worth It?

Prescription items per year Total cost without PPC Annual PPC cost (£111.60) Saving with PPC
6 items £59.40 £111.60 PPC not worth it
12 items £118.80 £111.60 £7.20 saving
24 items £237.60 £111.60 £126.00 saving
52 items (weekly prescription) £514.80 £111.60 £403.20 saving

The break-even point is 12 items per year. For anyone taking more than one regular medication, the annual PPC almost certainly saves money. A 3-month PPC (£31.25) covers 3 prescription items before breaking even — useful for short-term treatment courses.

PPCs can be purchased online via the NHS Business Services Authority website and paid for by Direct Debit instalments if preferred.

Help with Costs on a Low Income

The NHS Low Income Scheme provides help with NHS charges for people who are not automatically exempt but have a low income. Apply using form HC1:

  • Form HC1 is available from Jobcentre Plus offices, some GP surgeries, NHS dentists, hospitals, and pharmacies
  • If eligible, you receive an HC2 certificate (full help) or HC3 certificate (partial help)
  • HC2 covers prescriptions, dental treatment, sight tests, and glasses
  • HC3 reduces charges proportionally based on your income

You do not need to be on benefits to qualify — the scheme is income and savings based, not benefits-based.

Optical Costs — Free Eye Tests and Glasses Vouchers

The NHS also provides help with optical costs for eligible groups:

Free NHS eye tests are available for:

  • Children under 16
  • Young people in full-time education under 19
  • People aged 60 or over
  • People with diabetes or glaucoma (or at risk of glaucoma)
  • Registered blind or partially sighted people
  • Those receiving qualifying benefits (Universal Credit, Income Support, etc.)
  • People who need complex lenses

NHS glasses vouchers are available to eligible groups to contribute towards the cost of glasses or contact lenses. The voucher value depends on your lens prescription strength (typically £39.10 to £215.50 in 2026/27). If your chosen frames and lenses cost more than the voucher value, you pay the difference.

Wigs and Fabric Supports — Other NHS-Funded Items

Surgical wigs and fabric supports (including elastic hosiery) are available through the NHS at no charge for people on qualifying benefits or in eligible groups. Wigs are provided at a fixed NHS charge of £77.45 per wig (2026/27) for those not exempt.

What This Cluster Covers

Your question Best starting point
NHS charges and who is exempt NHS Costs and Exemptions Guide
NHS dental charges 2026/27 NHS Dental Charges 2026/27
Prescription Prepayment Certificates Prescription Prepayment Certificates