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Most people in England who pay for prescriptions never need a document beyond the prescription itself. The exceptions are a prepayment certificate, a medical exemption certificate and the refund receipt that comes with a charge you may later want back. Each has a rule that is easy to miss and expensive to learn the hard way. This page lists the rules and then sets out a small system for keeping the paper in one place.
It covers England. The NHSBSA runs these schemes, and the figures are the ones on its pages.
The refund receipt
If you pay a prescription charge and later want to claim it back, the document that matters is the refund receipt.
The NHSBSA says you can only get a refund if you were given an FP57 refund receipt when you paid. You cannot get one later, and you must claim within three months of paying the charge. So the habit is to ask for an FP57 form at the counter when you pay, and to tick it off on a note as soon as you get home. Without it, the claim has no document behind it.
The charge itself is £9.90 for each prescribed item, and there is a charge for each different medicine. Three items on one prescription is £29.70.
The prepayment certificate
A prepayment certificate costs £32.05 for three months or £114.50 for twelve. The 12-month version can be paid in ten monthly Direct Debit instalments, which works out at £11.45 a month. The NHS says the three-month certificate saves money if you need more than 3 prescribed items in 3 months, and the 12-month one if you need more than 11 items in a year.
Three practical rules are worth knowing.
- The start date. The NHS says the start date must be within one month before or after the date you apply. A certificate can therefore cover items you collected in the month before you applied. If that applies to you, keep the receipts for those items and the application date together.
- The certificate itself. You can receive it by email straight away, and a replacement paper certificate arrives within 10 working days, according to the NHSBSA. If you hold a digital one, save the email somewhere you can find it.
- If you become entitled to free prescriptions. The NHSBSA says you may get a refund of the certificate cost if you become entitled to free NHS prescriptions while it is valid. You claim by contacting NHS Help with Health Costs.
Write the end date on a calendar the day you buy the certificate. The calculator shows whether renewing is worth it, and the earlier article on what to do if you were wrongly charged covers the refund route in more detail.
The medical exemption certificate
A medical exemption certificate gives free prescriptions for people with one of the listed conditions. The conditions that qualify are set out in the exemption article, and the certificate is applied for through a GP or doctor, who provides a form.
The length of the certificate has changed. The NHSBSA page says you are entitled to a 5-year certificate if you are undergoing treatment for cancer, the effects of cancer or the effects of cancer treatment. It says you are entitled to a 10-year certificate if you have one of the other listed conditions, and also if you have one of those conditions while undergoing cancer-related treatments. It adds that if the NHSBSA received your application before 16 July 2026, your certificate will usually last 5 years. Check the expiry date printed on yours instead of assuming a length.
For renewals:
- The NHSBSA says it sends a reminder around one month before the certificate expires.
- You then speak to your GP or doctor and apply for a new one.
- A new certificate arrives in the post within 10 working days of the NHSBSA receiving the application, according to the page.
If you change your name, you need a new certificate. If you lose or damage one, contact the NHSBSA. Keep a note of the certificate's expiry date separate from the certificate, so a lost one does not also lose the date.
What to keep, and for how long
- FP57 refund receipts. Keep them until the claim is paid or the three months have passed.
- The prepayment certificate and the email it came in. Keep until it expires, and until any refund has been settled.
- The medical exemption certificate. Keep until it expires, and keep the renewal reminder.
- Receipts for items you collected before a prepayment certificate started. Keep them with the application date.
A small filing set-up
You need a place for each document and a reminder for each date.
- Ad A slim expanding wallet with a few pockets holds the certificate, the refund receipts and the expiry notes. It is small enough to stay with the medicines.
- Ad A card holder with a clear window suits a paper certificate that you need to show at the pharmacy.
- Ad A year wall calendar is where the end date of a prepayment certificate and the one-month renewal point for an exemption certificate go.
- Ad A pocket notebook keeps a running note of the dates you paid and the item counts.
- A phone reminder as well is fine. The paper copy is for when the phone is not to hand.
Setting up the habit
The rules above are simple, and the difficulty is remembering them at the counter. Three habits cover most of it.
- Ask for the FP57 form whenever you pay a charge, and put it straight into the wallet instead of a pocket or a bag.
- Photograph the receipt on the day, so there is a copy if the paper fades. A photo is a safer record than the original alone.
- Check the date on the certificate against the date on the calendar whenever you pick up a prescription, so you notice an approaching expiry while there is still time to act.
Someone else may collect your medicines for you. If so, tell them where the paperwork is kept and what to ask for at the counter, so the receipt does not go astray.
A yearly check
- Look at each end date and mark the date one month before it.
- File this year's refund receipts in a single pocket.
- Count the items collected this year, and compare the total against the prepayment certificate prices, using the guide.
- When the NHSBSA reminder for an exemption certificate arrives, speak to your GP about renewing.