Medical exemption: free NHS prescriptions for listed conditions

In England NHS prescriptions are charged, but a set list of conditions brings an exemption — the medical exemption certificate (MedEx). Many who qualify do not know it and pay needlessly.

What does the certificate give?

A MedEx entitles you to free NHS prescriptions. Without a valid certificate (or another ground) a prescription must be paid for, and wrongly ticking "exempt" can bring a penalty.

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Which conditions qualify?

The list is set in law. It includes, for example: cancer treatment (and the effects of cancer or its treatment), diabetes mellitus (except where treated by diet alone), epilepsy needing continuous anticonvulsant therapy, an underactive thyroid (myxoedema) needing hormone replacement, a permanent fistula needing dressing or an appliance, plus hypoadrenalism, diabetes insipidus, hypoparathyroidism, myasthenia gravis, and a continuing physical disability that prevents you going out without help.

How do you apply, and for how long?

You apply through your doctor, who gives you the form; once NHSBSA receives it, the certificate is posted within 10 working days. A cancer certificate lasts 5 years; for other conditions it lasts 10 years (for applications received before 16 July 2026 it usually lasted 5 years). Details and the full list are on the NHSBSA site.

What else matters?

If you are 60 or over, prescriptions in England are already free — no separate certificate is needed. A MedEx must be renewed: check the expiry date in good time. And if your condition is not on the list but you need many prescriptions, a prepayment certificate (PPC) is cheaper — a fixed charge for all prescriptions over 3 or 12 months.

What do you do while the certificate is being processed?

Processing takes time, but you may need prescriptions sooner. If you pay for a prescription while waiting, ask the pharmacy for an FP57 refund form (issued only at the time of payment) and reclaim the cost later if your entitlement is confirmed. For a short gap, a PPC is worth buying so you do not overpay for several prescriptions.

Why renew the certificate on time?

A MedEx lasts 5 or 10 years depending on the ground, but does not renew automatically. NHSBSA usually reminds you near expiry, but the responsibility is yours: you must not tick "exempt" with an expired certificate, as a penalty can follow. Check the expiry date and apply to renew in good time through your doctor. If you turn 60, you no longer need a separate certificate — prescriptions in England are free by default at that age.