Medical Exemption Certificates

Non-urgent advice: Please note

All medical exemption certificates due to expire between 14 December 2021 and 1 March 2022 will be extended for a further 6 months from the current date of expiry.

This was agreed by the Department of Health and Social Care to help reduce the workload for GP practices during the COVID-19 vaccination booster programme.

The NHSBSA is writing to all patients whose certificate expires in the given timeframe to provide more information. You do not need to take any action. You will receive a new certificate in the post. If you have already applied for a new certificate, you may receive two. Please keep the certificate with the longest expiry date.

People with certain medical conditions can get free NHS prescriptions if they have a valid medical exemption certificate.

A medical exemption certificate:

  • entitles you to free NHS prescriptions only
  • doesn’t cover dental treatment or help with other health costs
  • should be shown when you collect a prescription
  • is valid for five years (or until your 60th birthday, whichever is sooner)

It’s your responsibility to check the expiry date, and if you claim free prescriptions after your certificate expires, you could have to pay a penalty charge of up to £100.

Who can apply (medical conditions)

You can apply for a medical exemption certificate if you have one of the following medical conditions:

  • a permanent fistula (for example, caecostomy, colostomy, laryngostomy or ileostomy) which needs continuous surgical dressing or an appliance
  • a form of hypoadrenalism (for example, Addison’s Disease) for which specific substitution therapy is essential
  • diabetes insipidus and other forms of hypopituitarism
  • diabetes mellitus, except where treatment is by diet alone
  • hypoparathyroidism
  • myasthenia gravis
  • myxoedema (that is, hypothyroidism which needs thyroid hormone replacement)
  • epilepsy which needs continuous anticonvulsive therapy
  • a continuing physical disability which means you cannot go out without the help of another person
  • cancer and are undergoing treatment for either:
    • cancer
    • the effects of cancer
    • the effects of cancer treatment

These are the only conditions that entitle you to a medical exemption certificate. If you’re not sure about the name of your condition, speak to your doctor.

How to apply

If you’re entitled to a certificate because of your medical condition, your doctor will give you an application form.

You should expect to receive your certificate within 10 working days of us receiving your application. 

Refunds of prescription charges

If you need to pay prescription charges before your medical exemption certificate arrives, you can get a refund as long as:

  • you ask for an FP57 refund receipt when you pay (you can’t get one later)
  • the start date of your medical exemption certificate is the same or earlier than the date you pay for your prescription (certificates are backdated one month from the date that we receive your application – they can’t be backdated any further)

You must claim your refund within three months of paying.

The FP57 refund receipt tells you what to do.

Replace or renew your certificate

Replacing your certificate

If you lose or damage your certificate, we can send you a replacement. You’ll receive your replacement certificate within 10 working days.

Contact NHSBSA

Renewing your certificate

You need to speak to your doctor to re-apply.

We’ll send you a reminder around one month before your current certificate expires but it’ s your own responsibility to check that your certificate is still valid when you claim free prescriptions.

When your medical exemption certificate expires

It’s your responsibility to check the expiry date. If you claim free prescriptions after your certificate expires, you could have to pay a penalty charge of up to £100.

Change of circumstances

If your address changes, please contact NHSBSA so we can update our records.

If your name changes, we will update your certificate. You will need to send us your existing certificate, plus one of the following:

  • a copy of your marriage certificate
  • a copy of your civil partnership certificate
  • a copy of your deed poll
  • a copy of your passport
  • a copy of your Decree Absolute

NHS Help with Health Costs

NHS Business Services Authority
Bridge House,
152 Pilgrim Street,
Newcastle upon Tyne,
NE1 6SN 

Check if your certificate is valid

If you have a medical exemption certificate, you can check if it’s still valid or will expire soon.

If you’re not entitled to a medical exemption certificate

You could save money with a prescription prepayment certificate. Or, if you have a low income you may qualify for help through the NHS Low Income Scheme.