Health Insurance Guides
Does health insurance cover prescription medicines?
Key takeaways: Does health insurance cover prescription medicines?
The way health insurance covers GP appointments will depend on your insurer and the way your plan is set up. With some insurers you’ll get access to an online GP service. An online GP service offers you the convenience of being able to book appointments with fully qualified GPs that fit in around your other commitments.
You’ll usually be able to have phone or video consultations through your smartphone, tablet or computer. Most online GPs can issue prescriptions and fit notes, just like an NHS GP. If you have an appointment with an online GP, you can still see your NHS GP.
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Does health insurance cover prescription medicines?
Does health insurance ever cover prescription medicine?
Will my health insurer cover prescriptions if I use their GP service?
Will my health insurer pay for medicines I need after outpatient treatment?
Will health insurance cover medicines I need as an inpatient?
Does a private prescription cost the same as an NHS prescription?
How much will my medicine cost as a private prescription?
Who can get a free prescription under the NHS?
Does health insurance ever cover prescription medicine?
This will depend on your insurer and your individual plan.
A health insurer may sometimes pay for short-term medicine related to medical treatment they’ve approved, but they’ll rarely cover long-term repeat prescriptions.
Some insurers may provide cover for prescription drugs, such as for cancer treatment, but with limits on which drugs they’ll cover or how much you can claim. With others, you may be able to pay extra to add cover for prescription drugs to your plan. Your membership documents will tell you if your insurer covers prescription charges.
Will my health insurer cover prescriptions if I use their GP service?
This will vary depending on your insurer. However, health insurers often don’t cover the costs of prescription medicines even if they’re prescribed by the insurer’s GP service. Instead, you’ll get a private prescription which you’ll need to pay for yourself. You may also need to pay for delivery.
The GP service should give you a idea of the cost of the prescription. If you wish, you can instead ask your NHS GP for the same medicine via the NHS. However, they may not agree to prescribe this. Each NHS area has its own rules on which medicines a GP can prescribe.
Your insurer’s online GP service may only cover prescriptions within the UK.
See how AXA Health’s online GP service works.
Will my health insurer pay for medicines I need after outpatient treatment?
While your health insurance may pay for you to have outpatient treatment privately, it won’t always cover the cost of any outpatient medicines, dressings or other prescriptions that you need after having the treatment.
You often won’t be covered for:
- Medicines, dressings or other prescriptions you’re given to take home after you’ve had any kind of hospital treatment – as an outpatient, day patient or inpatient.
- Medicines, dressings or other prescriptions your GP could prescribe, or that you could buy without a prescription.
- Medicines you take, or are given, when you go to hospital for outpatient treatment.
Individual insurers might treat this differently, so it’s worth checking your membership documents to find out what you’re covered for.
Will health insurance cover medicines I need as an inpatient?
If you need inpatient or day patient treatment, you’ll usually be covered for any drugs you’re given as part of the treatment, such as anaesthetics. This is because the medicine is part of the treatment.
However, if you’re given a prescription or drugs to take home after the treatment, including painkillers, these may not be covered. Your membership documents will tell you what you’re covered for. If you’re not sure, it’s a good idea to contact your insurer before you go into hospital.
Does a private prescription cost the same as an NHS prescription?
Private prescriptions may cost more than NHS prescriptions. With the NHS, in England you pay a standard charge for a prescription – currently, that’s £9.90. In Scotland, Wales and Northern Ireland, you don’t have to pay. See who can get a free prescription under the NHS.
With a private prescription there’s no standard charge – you pay for the cost of the medicine, so what you pay depends on what the medicine is. It doesn’t matter if the prescription is for a child, or anyone else who doesn’t have to pay under the NHS.
If a private prescription is more expensive than the NHS, you can ask your NHS GP if they’ll prescribe the same medicine under the NHS. They will want to see you to make sure you need the medicine. They may not agree to give you the same prescription, as the NHS has different rules on prescriptions.
How much will my medicine cost as a private prescription?
Some commonly used medicines may cost less than the NHS standard fee (currently £9.90 per item). For example, some painkillers or common antibiotics may cost less than £9.90.
However, some medicines can cost much more than the NHS fee. You may also need to pay a delivery fee.
Can I still see my NHS GP if I use an online GP?
Yes. You’ll still be registered with your NHS GP. Using an online GP won’t affect this.
Who can get a free prescription under the NHS?
In the UK, only people in England pay for prescriptions. In Scotland, Wales and Northern Ireland, you don’t have to pay.
In England, some people can get free prescriptions, including:
- Children under 16, or under 18 if they’re in full-time education
- People over 60
- People with certain conditions, such as diabetes or cancer
- Pregnant people.
Some medicines, such as birth control, are prescribed for free by the NHS. If you have a regular prescription, you can also save money by buying a pre-payment certificate that covers all prescriptions for a year.
Check whether you can get free prescriptions or other help with NHS costs