Current eligibility for free prescriptions
In England, there are multiple exemptions from paying the standard NHS prescription charge. For pensioners, the most straightforward is the age-based exemption.
- Aged 60 or over: Any person aged 60 or over is automatically entitled to free NHS prescriptions. They do not need to apply for this, though they may be asked to show proof of age at the pharmacy.
- Other exemptions: Beyond the age criterion, other groups qualify for free prescriptions. These include pregnant women, those with specific medical conditions and a valid medical exemption certificate, those on certain income-based benefits, and people with a valid war pension exemption certificate.
The government's consultation on raising the age
In 2021, the Department of Health and Social Care (DHSC) launched a public consultation on whether to raise the qualifying age for free NHS prescriptions in England. The proposal was to align it with the State Pension age (SPA), which is currently 66 and is legislated to increase further in future years.
The consultation was based on the premise that as life expectancy has increased and the SPA has risen, many people between the ages of 60 and 65 remain economically active and are therefore considered more able to afford their prescription costs.
The government outlined two main options during the consultation period:
- Option A: Raise the age for everyone to 66. This would have meant people aged 65 and under would need to pay until they reached 66, unless they qualified for another exemption.
- Option B: Raise the age to 66 but with a transitional protection period. This would allow those already aged 60–65 to retain their free prescriptions, but new 60-year-olds would have to pay until they reached the new exemption age.
Why the change was proposed
Several factors motivated the consultation to change the age-based exemption:
- Revenue generation: The DHSC noted that aligning the exemption with the SPA could generate additional revenue for NHS frontline services.
- Increased life expectancy: With people living longer and healthier lives, the argument was made that older adults are more able to afford their health costs.
- Aligning with state pension age: The current system, where free prescriptions start at 60 while the SPA is higher, was viewed as a disconnect.
Arguments against the proposed change
The consultation also highlighted several potential negative impacts, which were raised by those opposing the change:
- Impact on health: Concerns were raised that raising the age would deter some individuals, particularly those on low incomes, from collecting their prescribed medicines due to cost. This could lead to a decline in their health and potentially increase NHS costs in other areas, such as hospital admissions.
- Unfair impact on certain groups: Analyses showed that raising the exemption age could disproportionately affect women and those from socioeconomically deprived backgrounds, who are more likely to have long-term conditions requiring regular medication.
- Complexity and confusion: Introducing changes could cause confusion for patients and lead to an increase in penalty charges for those who mistakenly claim free prescriptions.
The outcome of the consultation
After significant opposition from various groups, including campaigners and some politicians, the government's plans to increase the prescription exemption age were reportedly scrapped. While the consultation concluded in 2021, no changes to the age-based exemption have been implemented. The DHSC confirmed that the upper age exemption for prescriptions remains at 60.
Comparison of prescription entitlements: England vs. Other UK Nations
| Feature | England | Scotland | Wales | Northern Ireland |
|---|---|---|---|---|
| Prescription charges | Applicable for those under 60. | Abolished (free for all). | Abolished (free for all). | Abolished (free for all). |
| Pensioner exemption | Free for those aged 60 and over. | Not applicable, as all prescriptions are free. | Not applicable, as all prescriptions are free. | Not applicable, as all prescriptions are free. |
| Proposed changes | Consultation to align with State Pension age was launched but is stalled. | No current changes proposed. | No current changes proposed. | No current changes proposed. |
| Low-income support | Yes, via the NHS Low Income Scheme (HC2 certificate). | Not applicable. | Not applicable. | Not applicable. |
| Pre-payment options | Yes, for those paying for multiple items per year. | Not applicable. | Not applicable. | Not applicable. |
What to do if you need help with costs
If you are under 60 and concerned about prescription costs, or if the rules change in the future, several options are available.
- Prescription Prepayment Certificate (PPC): For those who need frequent prescriptions, a PPC can cap the cost. You pay a set price for all your prescriptions over three or twelve months. This can be a significant saving for people who use multiple items regularly.
- NHS Low Income Scheme: Individuals and families on a low income, even if they do not receive qualifying benefits, can apply for help with health costs through the NHS Low Income Scheme. This can result in a certificate for either full (HC2) or partial (HC3) help with health costs.
- Medical exemptions: If you have a specific long-term medical condition, you may be entitled to a medical exemption certificate (MedEx), which provides free prescriptions for five years.
For authoritative guidance on NHS prescription exemptions and costs, refer to the official NHSBSA website at https://www.nhsbsa.nhs.uk/.
Conclusion: The current situation
To date, there has been no change to the rule that grants free NHS prescriptions to everyone in England aged 60 and over. While a consultation to increase this age was proposed, it has not moved forward, and the government has reaffirmed the existing exemption. For those under 60, support is available through PPCs and the NHS Low Income Scheme to manage health costs effectively. This ensures that essential medication remains accessible, regardless of one's financial situation.
