Angry about NHS penalty charges

jammerr

Hello,

My partner was claiming for ESA for a few months following losing her job. Following therapy after suffering stress she is on medication (was taking medication before this but have now upped dosage)

She has been paying for her medication but on two occasions claimed for free prescription whilst on ESA. She had not been doing any work whilst claiming this benefit.

To our surprise, she has received two letters asking for a penalty charge, She challenged the first one as when you sign for a free prescription you can tick the 'I am in receipt of JSA/ESA'

They have replied with the following (paraphrasing from a few emails)

'The prescription is stated with Income related Employment support allowance and not ESA. Contributions based benefits to do not entitle you to free prescriptions.

Your Benefit award Notice will confirm whether you are claiming Income related or Contributions based benefits.

It's your responsibility to ensure the information provided on your prescription / declaration is accurate and therefore the validity of your exemption should be checked each time you collect a prescription.'

'However we can confirm that Employment and Support Allowance (ESA) is calculated in two ways:

Contributions Based - this doesn't entitle you to free NHS prescriptions

Income Related - you can claim free NHS prescriptions
The exemption category on the prescription form, FP10, states you must be in receipt of income related ESA.

As the letter you've supplied states that you were in receipt of a contributions based benefit at the time, we're unable to remove the penalty charge.

'I've reviewed the evidence you've sent and I can confirm it doesn't show you are entitled to free NHS prescriptions. This is because your award letter shows you receive a contributions based benefit which doesn't automatically entitle you to free NHS prescriptions.

As you're not exempt, you're still required to pay the penalty'

I am so angry about this. My partner is still not working and taking medication. This was the first time she'd ever claimed any benefit - and she claimed the free prescription in good faith. How on earth would she know about FP10s and what counts as ESA and what doesn't?

Of course if she knew this should would have never had tried to claim a free prescription - all for the sake of £16 to be landed with huge fines. I expect better from the NHS and what a confusing benefits system.

Is there any way to fight this and offer to pay the costs but NOT the penalty? I would be happy to fight this further as I think when ticking a box that asks a question 'are you in receipt of ESA' and shes ticked yes - to be told its not the right type and hit with £88 fee is outrageous.

Advice appreciated

poppy12345

They are correct, it's your responsibility to know whether you're entitled to free prescriptions or not and you should always check before ticking any boxes. In pharmacies where i live there's notices up telling you to make sure you're claiming the correct benefits before ticking the boxes.



Ignorance most likely won't help her here.


The NHS low income scheme maybe possible here. https://www.nhsbsa.nhs.uk/nhs-low-income-scheme

Caz3121

there is a pic here of the FP10 form which shows she will have ticked that she was receiving income-related ESA
https://forums.moneysavingexpert.com/showpost.php?p=68536905&postcount=2
With contribution based benefits you can have £100k in the bank and a partner earning £100k+ salary so it is not an automatic right to free prescriptions
Income related would mean no savings over £16k and a partner not working 24 hours per week or more
Can she check the letters she has had re her ESA, it should be clear that it is contribution based...

[Deleted User]

The back of the prescription clearly states “income based ESA” because her benefits award letter specifies “contribution based” she should never of ticked that box and signed.

She therefore gave false information.

The penalty charge is correct.

calcotti

You are right to be angry. The system is confusing and the exemptions list assumes a knowledge of benefits that claimants may not have. I completely understand why she may not have realised that there are two types of ESA. However the claim was incorrect and you are unlikely to persuade them to waive the penalty although you can obviously try.

The penalties system is, in my opinion, punitive and particularly irritating as it only applies in England because all prescriptions in Wales, Scotland and Northern Ireland are free anyway.

TELLIT01

calcotti wrote: »

You are right to be angry. The system is confusing and the exemptions list assumes a knowledge of benefits that claimants may not have. I completely understand why she may not have realised that there are two types of ESA. However the claim was incorrect and you are unlikely to persuade them to waive the penalty although you can obviously try.

The penalties system is, in my opinion, punitive and particularly irritating as it only applies in England because all prescriptions in Wales, Scotland and Northern Ireland are free anyway.

Generally I would agree with this, but in this instance it would seem that the award letter did state Contribution Based so there is little basis to argue that they didn't have the required information to tick the correct box.
Arguing that prescriptions are free in other parts of the UK won't achieve anything as they have devolved powers in this area.

Muttleythefrog

calcotti wrote: »

You are right to be angry. The system is confusing and the exemptions list assumes a knowledge of benefits that claimants may not have. I completely understand why she may not have realised that there are two types of ESA. However the claim was incorrect and you are unlikely to persuade them to waive the penalty although you can obviously try.

The penalties system is, in my opinion, punitive and particularly irritating as it only applies in England because all prescriptions in Wales, Scotland and Northern Ireland are free anyway.

I have some sympathy too.... not least because not only is it confusing potentially to ordinary members of the public but the experts (namely those taking decisions at the NHSBSA) are also not benefits experts as I have found when it comes to adding into the mix immigration rules... and that was also in relation to ESA.

I would be inclined to take the matter further if she would otherwise qualify for help with healthcare costs... but it may be irrelevant or futile.

calcotti

TELLIT01 wrote: »

Generally I would agree with this, but in this instance it would seem that the award letter did state Contribution Based so there is little basis to argue that they didn't have the required information to tick the correct box.
Arguing that prescriptions are free in other parts of the UK won't achieve anything as they have devolved powers in this area.

I agree that they can’t argue that which is why I said they are unlikely to get the penalty waived. However I do sympathise with anyone making the error. For a claimant not familiar with the benefits system I think it completely understandable that the distinction between income based and contribution based benefit could be lost on them.

Similarly I wasn’t suggesting that referencing other parts of the UK would help with appealing the penalty. Again I was simply sympathising with OP’s anger. Seeing how many people in England are being caught out with NHS penalties is particularly irritating when other parts of the (so-called) UK do not have this problem because they take a more enlightened approach to supporting people in need of prescribed medication.

Unfortuntely I do agree that OP will have to pay up.

tboo

jammerr wrote: »

Hello,

My partner was claiming for ESA for a few months following losing her job. Following therapy after suffering stress she is on medication (was taking medication before this but have now upped dosage)

She has been paying for her medication but on two occasions claimed for free prescription whilst on ESA. She had not been doing any work whilst claiming this benefit.

To our surprise, she has received two letters asking for a penalty charge, She challenged the first one as when you sign for a free prescription you can tick the 'I am in receipt of JSA/ESA'

They have replied with the following (paraphrasing from a few emails)

'The prescription is stated with Income related Employment support allowance and not ESA. Contributions based benefits to do not entitle you to free prescriptions.

Your Benefit award Notice will confirm whether you are claiming Income related or Contributions based benefits.

It's your responsibility to ensure the information provided on your prescription / declaration is accurate and therefore the validity of your exemption should be checked each time you collect a prescription.'

'However we can confirm that Employment and Support Allowance (ESA) is calculated in two ways:

Contributions Based - this doesn't entitle you to free NHS prescriptions

Income Related - you can claim free NHS prescriptions
The exemption category on the prescription form, FP10, states you must be in receipt of income related ESA.

As the letter you've supplied states that you were in receipt of a contributions based benefit at the time, we're unable to remove the penalty charge.

'I've reviewed the evidence you've sent and I can confirm it doesn't show you are entitled to free NHS prescriptions. This is because your award letter shows you receive a contributions based benefit which doesn't automatically entitle you to free NHS prescriptions.

As you're not exempt, you're still required to pay the penalty'

I am so angry about this. My partner is still not working and taking medication. This was the first time she'd ever claimed any benefit - and she claimed the free prescription in good faith. How on earth would she know about FP10s and what counts as ESA and what doesn't?

Of course if she knew this should would have never had tried to claim a free prescription - all for the sake of £16 to be landed with huge fines. I expect better from the NHS and what a confusing benefits system.

Is there any way to fight this and offer to pay the costs but NOT the penalty? I would be happy to fight this further as I think when ticking a box that asks a question 'are you in receipt of ESA' and shes ticked yes - to be told its not the right type and hit with £88 fee is outrageous.

Advice appreciated

If in doubt ask

jammerr

Thanks for those that have shown some sympathy!

The benefits system is confusing, had no idea there two types of ESA having only claimed benefits for around 6 months of her working life. Then you get hit for trying to 'scam the system' and it leaves a bitter taste and causes further problems. I'm just glad she only tried it twice otherwise we'd have an ugly bill to pay. It's now worsened her condition now the letters have come through.

I'll be writing to them to explain what happened and hope they relent and also writing to our MP. The form could have been made much clearer.

Feel sorry for anyone trying to navigate through the world of universal credit!

[Deleted User]

The form is clear though, it says income based ESA and If you don't know which ESA you receive then you should check before committing to the signature to the form because you have therefore supplied false information, and even if you don't have a letter you can ring the DWP for clarification.