Medical exemption certificates

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.

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 certificate in the post within 10 working days of us receiving your application. 

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.

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.

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: 270KB) for details of PPC refund arrangements.

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.

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