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

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.