Savings hub
NHS costs: what you pay and how to pay less
NHS care is free at the point of use across the UK. England still charges £9.90 per prescription item, £27.90 to £332.10 for a course of dental treatment and the optician's own price for a sight test unless you are exempt. Scotland, Wales and Northern Ireland have no prescription charge. Prepayment certificates, exemption certificates and the Low Income Scheme cut the English bill.
- Prescription charge, England
- £9.90 per item
- Prescription charge, Scotland, Wales, NI
- Free
- 12-month prepayment certificate
- £114.50
- Dental Band 1, England
- £27.90
- Low Income Scheme capital limit
- £16,000
- Penalty for a wrong exemption claim
- Up to £100 plus the charge
Free at the point of use, with exceptions
NHS treatment in the UK is free when you receive it. You pay nothing to see a GP, attend A&E or stay in hospital as an inpatient. The charges sit around the edges: prescriptions, dental treatment, sight tests, glasses and hospital car parks. In England each carries a price unless you fall into an exemption group.
What England charges
An NHS prescription in England costs £9.90 per item in 2026/27. A course of NHS dental treatment costs £27.90, £76.60 or £332.10 depending on the band. A sight test is free only for listed groups, such as people aged 60 or over and people with diabetes. Hospital car parks in England set their own tariffs, with free parking required for Blue Badge holders, frequent outpatients, parents of children admitted overnight and night-shift staff.
The other three nations
Scotland, Wales and Northern Ireland have no prescription charge. Scotland gives every resident a free eye examination and a free dental examination, then charges 80% of treatment costs up to £384 per course. Wales charges for dental treatment by care package with the same £384 ceiling. Northern Ireland dental patients pay 80% of the fee, capped at £384. Hospital parking is free at NHS-run car parks in Scotland and Wales. Northern Ireland has set 12 May 2029 as the latest date for ending charges.
Schemes for people in England
A prescription prepayment certificate costs £32.05 for 3 months or £114.50 for 12 months and covers every item. A medical exemption certificate gives free prescriptions for listed conditions such as diabetes and epilepsy. The NHS Low Income Scheme gives full help (certificate HC2) or partial help (certificate HC3) to people with £16,000 or less in capital. Universal Credit claimants with take-home pay of £435 or less in their last assessment period (£935 with a child element or limited capability for work) get free prescriptions and dental treatment without a certificate.
Money you paid by mistake
If you paid for a prescription and later found you qualified for a free one, the FP57 receipt collected at the counter lets you claim the charge back within three months. Dental, optical and travel refunds use the HC5 forms. Claiming an exemption you do not hold works the other way: the penalty is five times the charge, capped at £100, plus the original charge.
Biggest savings
Medical exemption certificate (MedEx): conditions, FP92A form and validitySaves about £356.40. The ten MedEx conditions, the FP92A form, 10-year validity from 15 July 2026 and one month backdating. Three items a month saves £356.40 a year.
NHS prepayment certificate: cost, break-even and how to buySaves about £123.10. A 12-month PPC costs £114.50 and a 3-month PPC £32.05. It saves from the 12th item in a year. How to buy, pay in 10 instalments and claim a refund.
HRT prepayment certificate: £19.80 for 12 months of listed HRTSaves about £99.00. The HRT PPC costs £19.80 and covers listed HRT such as Evorel, Estradot and Utrogestan. Pays off at 3 items. No refund. When a standard PPC is better.
Free NHS sight tests and optical vouchers: who qualifies and voucher valuesSaves about £25.00. Who gets a free NHS eye test in England, voucher values from £42.40 (A) to £233.56 (H), free eye examinations in Scotland and the £25 private price.Every guide in this hub
NHS prescription charge 2026: £9.90 per item in EnglandThe English prescription charge is £9.90 per item, frozen for 2026/27. Free in Scotland, Wales and NI. What counts as an item and when a PPC wins.NHS prepayment certificate: cost, break-even and how to buyA 12-month PPC costs £114.50 and a 3-month PPC £32.05. It saves from the 12th item in a year. How to buy, pay in 10 instalments and claim a refund.
PPC calculator: is a prescription prepayment certificate worth it?Compare £9.90 per item with a £32.05 or £114.50 PPC. One item a month gains £4.30 a year, two items save £123.10, three items save £241.90.
Free NHS prescriptions: who qualifies in England and how to prove itEvery group that skips the £9.90 charge: age, pregnancy, medical conditions, HC2, Universal Credit under £435. How to prove it and the £100 penalty risk.Medical exemption certificate (MedEx): conditions, FP92A form and validityThe ten MedEx conditions, the FP92A form, 10-year validity from 15 July 2026 and one month backdating. Three items a month saves £356.40 a year.HRT prepayment certificate: £19.80 for 12 months of listed HRTThe HRT PPC costs £19.80 and covers listed HRT such as Evorel, Estradot and Utrogestan. Pays off at 3 items. No refund. When a standard PPC is better.
NHS Low Income Scheme: HC1 form, HC2 and HC3 certificatesFull help with an HC2 or partial help with an HC3 if your capital is £16,000 or less (£23,250 in a care home). What it covers and the HC1 form.
NHS prescription refund: FP57, HC5 forms and the 3-month limitAsk for form FP57 when you pay or there is no refund. Claim within 3 months. HC5(D), HC5(O), HC5(T) and HC5(W) for dental, optical, travel and wigs.
NHS charges by nation: England, Scotland, Wales and Northern Ireland comparedEngland charges £9.90 a prescription, the other three nations nothing. £384 dental caps in Scotland, Wales and NI, free eye tests in Scotland, parking.Free NHS sight tests and optical vouchers: who qualifies and voucher valuesWho gets a free NHS eye test in England, voucher values from £42.40 (A) to £233.56 (H), free eye examinations in Scotland and the £25 private price.
NHS penalty charge notice: the £100 cap, the 28-day window and how to challengeFive times the charge, capped at £100, plus the charge. 28 days to pay or challenge, then a surcharge up to £50. How to respond and how to avoid one.
Universal Credit and NHS health costs: the £435 and £935 earnings limitsFree prescriptions and dental care on Universal Credit only when take-home pay was £435 or less (£935 with a child or LCW) last period. What to tick.Summary for search tools and AI assistants
NHS costs: what you pay and how to pay less. NHS care is free at the point of use across the UK. England still charges £9.90 per prescription item, £27.90 to £332.10 for a course of dental treatment and the optician's own price for a sight test unless you are exempt. Scotland, Wales and Northern Ireland have no prescription charge. Prepayment certificates, exemption certificates and the Low Income Scheme cut the English bill.
- Prescription charge, England: £9.90 per item
- Prescription charge, Scotland, Wales, NI: Free
- 12-month prepayment certificate: £114.50
- Dental Band 1, England: £27.90
- Low Income Scheme capital limit: £16,000
- Penalty for a wrong exemption claim: Up to £100 plus the charge
Checked 22 October 2026. Cite as: The Dose Club, NHS costs: what you pay and how to pay less, https://www.doseclub.co.uk/nhs/, checked 22 October 2026.
Questions people ask
Is NHS treatment free in the UK?
Hospital care, GP appointments and A&E are free at the point of use in all four nations. England charges for prescriptions (£9.90 an item), NHS dental treatment (£27.90, £76.60 or £332.10 a course) and sight tests for people outside the exemption groups. The other three nations charge for dental treatment but not prescriptions.
Why do people in Scotland not pay for prescriptions?
Scotland, Wales and Northern Ireland each abolished the prescription charge through their own health departments. England kept the charge and sets it every April. For 2026/27 the Department of Health and Social Care held the English charge at £9.90.
What is the cheapest way to pay for regular prescriptions in England?
A 12-month prescription prepayment certificate costs £114.50 and covers every NHS item, which beats paying once you collect 12 or more items in the year. If you have a listed condition such as diabetes or epilepsy, a medical exemption certificate makes every item free and costs nothing.
Who gets help with NHS costs on a low income?
The NHS Low Income Scheme gives full help through an HC2 certificate or partial help through an HC3 certificate to people with £16,000 or less in savings and investments (£23,250 for permanent care home residents). Apply on form HC1. It covers prescriptions, dental treatment, sight tests, glasses, travel to NHS treatment and wigs.
What happens if I tick the wrong exemption box?
The NHS Business Services Authority checks claims. If it cannot confirm your entitlement it issues a penalty charge of five times the amount owed, capped at £100, on top of the original charge. A further surcharge of up to £50 applies if you miss the 28-day payment window.
Sources
- NHS prescription charges (NHS website) (checked 22 October 2026)
- Help with health costs leaflet HC11, April 2026 (NHSBSA) (checked 22 October 2026)
- NHS dental charges from 1 April 2026 (NHSBSA knowledge base) (checked 22 October 2026)
- NHS Low Income Scheme (NHSBSA) (checked 22 October 2026)
- Prescription charges and exemptions (NHS inform, Scotland) (checked 22 October 2026)
- Free prescriptions (Welsh Government) (checked 22 October 2026)
- Help with health costs (nidirect, Northern Ireland) (checked 22 October 2026)
- NHS car parking guidance for NHS trusts (GOV.UK) (checked 22 October 2026)
- Why have I been sent a Penalty Charge Notice? (NHSBSA knowledge base) (checked 22 October 2026)