Costs compared
What NHS treatment actually costs in 2026: prescriptions, dentistry and the four nations
Most NHS care is free at the point of use. Three things are not: prescriptions in England, dentistry, and optical services. Here are the 2026/27 figures, the differences between the four nations, and the point at which a prepayment certificate stops being optional and starts being obvious.
In short
- The England prescription charge is frozen at £9.90 per item for 2026/27.
- A 12-month prepayment certificate costs £114.50 and pays for itself at 12 items a year.
- Prescriptions are free to all residents in Scotland, Wales and Northern Ireland.
- NHS dental charges in England rose in April 2026 to £27.90, £76.60 and £332.10.
Prescriptions in England
The charge is £9.90 per item, not per prescription form. Three medicines on one form cost £29.70. The charge has been frozen at this level for a second consecutive year for 2026/27, so it is the same figure you paid last year.
Roughly nine in ten prescription items dispensed in England are already free, because the exemption categories are broad: children under 16, 16 to 18 year olds in full-time education, everyone aged 60 and over, pregnant women and those who have given birth in the last twelve months, people with a valid medical exemption certificate, and people on certain benefits.
When a prepayment certificate is worth it
| Certificate | Cost | Worth it if you need |
|---|---|---|
| 3-month PPC | £32.05 | More than 3 items in 3 months |
| 12-month PPC | £114.50 | More than 11 items in 12 months |
| 12-month HRT PPC | £19.80 | Any regular HRT prescription |
The 12-month certificate can be paid in ten monthly direct debit instalments, which matters if the up-front figure is the obstacle. The HRT certificate is a special case: at £19.80 for a year it covers all listed HRT items and is almost always worth buying if you collect any HRT prescription at all.
NHS dentistry in England
Dental charges rose from 1 April 2026. You pay one band charge per course of treatment, not per procedure, and the band is set by the most complex item in the course.
| Band | Covers | Charge |
|---|---|---|
| Band 1 | Examination, X-rays, scale and polish if clinically needed | £27.90 |
| Band 2 | Band 1 plus fillings, extractions, root canal work | £76.60 |
| Band 3 | Bands 1 and 2 plus crowns, dentures, bridges | £332.10 |
| Urgent treatment | Pain relief, temporary filling | £27.90 |
The practical consequence of per-course charging is that it pays to have everything done in one course rather than returning repeatedly. If you need a check-up, two fillings and a crown, that is one Band 3 charge of £332.10, not the three charges added together.
The four nations compared
| Nation | Prescriptions | Dentistry |
|---|---|---|
| England | £9.90 per item | Three bands: £27.90 / £76.60 / £332.10 |
| Scotland | Free for all residents | Free examination; treatment capped per course; free for under-26s |
| Wales | Free for all residents | New contract from April 2026 with a per-course cap |
| Northern Ireland | Free for all residents | Item-of-service charging with a per-course cap |
Prepayment certificates are an England-only instrument. There is nothing to prepay elsewhere.
NHS versus private
Going private buys speed and choice of consultant, not a different clinical standard, and it does not remove you from the NHS. A common and legitimate pattern is a private diagnostic consultation followed by NHS treatment, since the consultant can write to your GP. Two cautions: private treatment is not covered by any NHS charge cap, and if a complication arises you return to the NHS pathway, sometimes at the back of the queue.
If cost is the pressure point rather than speed, read the help with health costs guide before assuming you have to pay at all.
Common questions
Do I pay the prescription charge if I am on Universal Credit?
It depends on your earnings in the relevant assessment period. There is an earnings threshold, and being on Universal Credit does not automatically exempt you. Check before you collect.
What if I pay and later find I was exempt?
Ask the pharmacy for an FP57 receipt at the moment you pay. You cannot get one later, and without it you cannot claim the refund.
Does a prepayment certificate cover dental charges?
No. It covers prescription items only.
Are eye tests free?
Free NHS sight tests are available to defined groups, including people aged 60 and over, and everyone in Scotland. Elsewhere most working-age adults pay.