How do i get a new NHS exemption card

A medical exemption certificate entitles you to free NHS prescriptions.

Find out if you’re entitled to NHS dental treatment and other help with health cost using the NHS eligibility checker.

Check your medical exemption certificate is valid

Check that your exemption certificate is valid before claiming free NHS prescriptions.

Who is entitled (medical conditions)

You're entitled to a medical exemption certificate if you have either:

  • 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 you can apply

If you're entitled to a certificate because of your medical condition, speak to your GP or doctor. They'll give you an application form.

You'll get a paper certificate in the post within 10 working days of us receiving your application. 

How long it is valid for

When it starts

We will backdate the certificate to start one month before the date we receive your application.

If your certificate covers the date you collect your items, you can get your NHS prescriptions for free.

Mark box ‘E’ on the prescription form and sign the declaration.

You may need to show your certificate as evidence that your exemption is valid. You can still collect your NHS prescription for free if you do not have your certificate with you.

When it expires

Your certificate will normally last for 5 years and then you will need to renew it.

Remember NHS prescriptions are free if you’re aged 60 or over.

Renew your certificate

You need to speak to your GP or doctor to apply for a new certificate.

We'll send you a reminder around one month before your current certificate expires. It's your own responsibility to check that your certificate is valid when you claim free NHS prescriptions.

Claiming refunds

NHS prescription charges

You may get an NHS prescription charge refund if:

  • you get an NHS refund form (FP57) when you pay - you cannot get one later
  • your medical exemption certificate covers the date you paid for your NHS prescription

The FP57 tells you how to claim. 

You need to apply for a refund within three months of paying the prescription charge.

NHS Prescription Prepayment Certificate (PPC) fees

If you hold a valid PPC, you may be entitled to a refund. Read the HC11 booklet (PDF: 152KB) for details of PPC refund arrangements.

How to report a change in details or an error

Make sure the details on the certificate are correct and are kept up to date. 

If you change your name, you’ll need a new certificate. Return the certificate to us with a copy of either your:

  • marriage certificate
  • civil partnership certificate
  • deed poll
  • passport
  • decree absolute 

If you change address or notice any errors on your certificate, contact us.

Lost or damaged certificates

If you lose or damage your certificate, contact us. We can send you a replacement. 

To renew your MEDEX, you'll need to speak to your GP who will complete a new FP92a application form.

A MEDEX is valid for 5 years.

We'll send a letter reminding you that your MEDEX is about to expire one month before the expiry date if you’re under the age of 60. If you’re over the age of 60, you're already entitled to free NHS prescriptions and do not need to apply for a new certificate.

If your MEDEX expires before your new certificate arrives, you must pay for your medication and ask the pharmacy for a FP57 refund receipt. Once your MEDEX arrives, if it covers the date of the payment, take your FP57 refund receipt and MEDEX to any pharmacy and they'll refund you. All prescription refunds must be made within 3 months of payment.

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How do I replace my medical exemption card?

You need to speak to your GP or doctor to apply for a new certificate. We'll send you a reminder around one month before your current certificate expires. It's your own responsibility to check that your certificate is valid when you claim free NHS prescriptions.

How do I get a copy of my NHS exemption certificate?

If your NHS tax credit exemption certificate has been lost, stolen, or destroyed you can request a replacement by contacting us directly:.
Online: using our online form..
Telephone: 0300 330 1347..
Facebook: NHS Help with Health Costs..
Twitter: @nhshealthcosts..

How do I contact NHS for exemption?

Queries about medical exemption certificates – 0300 330 1341. Queries about prescription prepayment certificates (PPCs) – 0300 330 1341. Queries about tax credit certificates – 0300 330 1347.

How do I renew my NHS tax credit exemption certificate?

If your NHS tax credit exemption certificate has expired, we will automatically send you a new one providing Her Majesty's Revenue and Customs (HMRC) tells us you still qualify. If you do not qualify, a new certificate will not be sent.