Pre pay prescription penalty of over £1300 - Disastrous Loophole for those reaching 60 with a PPC

Aliforce

I have had a pre pay prescription certificate for about a decade, back when they used to be actual credit card type cards. For all this time I’ve had a notification of the certificate being up for renewal and it’s ALWAYS been auto-renewed. So when my letter came in February I didn’t take much notice of it but put it in a drawer. I did however email them to ask them how I got a refund when I turn 60 and they advised me that as you turn 60 you can get a refund for the remainder of the year. Fine. I merrily went on my way until last week when I got a letter advising me I didn’t have an exemption and they were going to fine me for ticking the box on the prescription form. I assumed this was a mistake but lo and behold when I went to my bank and did a search, sure enough, it hadn’t been renewed. I panic. Look back at the original letter and see that without fanfare they told me it wouldn’t be renewed, with no reason why. Immediately purchase a 3 month certificate to tide me over and I’m a reasonable person so I think, OK I’ve made a mistake, I’ll pay the fine which is prescription cost + up to £100, though they could have made it a bit more obvious it was going to stop. 

So I email them back, and say I’ve checked but I want to complain as it wasn’t made obvious on the letter and I’ve been doing this for a decade now so it was a reasonable assumption it would renew. Get an email back saying, well you didn’t have a certificate so you need to pay a penalty charge. And the amount of the charge is going to be over £1300. I burst into tears immediately. Who on earth came up with this figure and how is this proportionate when I’ve not been fraudulently trying to claim but, as a long standing user of the service, I have made an honest mistake due to miscommunication. 

I’m going to appeal, but honestly, I was upset and now I’m angry. How can this be right? All 59 year old users of this service will be having the same issues. Why is cancelling now the default, and how can they justify this figure? It’s seems so punitive, especially as the very users of this service are those most likely to have chronic health conditions like me. I’ve not had the official PCN so I don’t even know how they’ve come up with it? I’ve asked for a breakdown of the figure today but no idea when I’ll hear back. 

Would be grateful for any advice or experiences on this. 

sheramber

You admit you did not read the communication that they sent you telling you the certificate would not renew.

How many prescriptions have you had since your certificate ran out?

The penalty charge If the NHS finds that you have wrongly claimed free or reduced-cost treatment, you may be guilty of an offence and you may have to pay a penalty charge. In some cases you may be prosecuted. The penalty charge is a civil fine – it is five times the amount you should have paid, up to £100. This is on top of the original charge. The NHS will take action in the civil courts if necessary. For example, (at 2023 rates) if you wrongly claim free prescriptions for two items (£19.30), you will have to pay a penalty charge of 96.50 (5 x £19.30) plus £19.30 for the actual prescription charges. If you wrongly claim free dental treatment (at 24 April 2023 rates) at the lowest rate (£25.80), you will have to pay a penalty charge of £100.00 (5 x £25.80 = £129.00 subject to a maximum of £100) plus £25.80 for the actual dental charge. You can find more information about penalty charges from the following. • www.nhsbsa.nhs.uk/nhs-penalty-charges • Phone 0300 330 9291.

DullGreyGuy

Aliforce said:
when my letter came in February I didn’t take much notice of it but put it in a drawer. I did however email them to ask them how I got a refund when I turn 60 and they advised me that as you turn 60 you can get a refund for the remainder of the year. Fine. I merrily went on my way until last week when I got a letter advising me I didn’t have an exemption and they were going to fine me for ticking the box on the prescription form. I assumed this was a mistake but lo and behold when I went to my bank and did a search, sure enough, it hadn’t been renewed. I panic. Look back at the original letter and see that without fanfare they told me it wouldn’t be renewed, with no reason why

So did you look at the letter at all before "filing" it?

Do you not check your bank statements?

I'm not sure what fanfare you are hoping for but in most cases writing a letter to a customer at their last known address is considered sufficient notice. In work we get it all the time where people ignore their renewal letter and then complain after that we have renewed them (there are 2 complaints on this forum today about things renewing because the person didnt read the email/letter) "without telling them". Making an assumption the letter will say the same as last year is dangerous.


Having a medical exemption I've had one case where my cert had run out, I'd sent the forms for a new one but they claim they didnt receive them and I didnt spot the lack of a new card and then got the letter about being fined. On speaking to them they advised if I got a new exemption in the investigation/appeal period then I'd have to pay the prescription charge but the penalty would be waived. No idea if with pre-pay there is any similar type of route available (though with medical exemption it is really a technicality of a fine... until a cure for diabetes is found anyway)

HillStreetBlues

Without seeing the letter can't comment on how better they could have made it.

But the bottom line is they did write and tell you, so did their duty of informing you.

Hopefully you will get some sort of reduced fines.

Aliforce

DullGreyGuy: Of course I realise with the benefit of hindsight that I made an honest mistake. I have various health issues to deal with so I’m not always firing on both cylinders. i’ve said as much in my original post, so I wasn’t expecting a fanfare. My real beef is the scale of this charge and the fact that I’m surely not on my own. The other people I have spoken to about it who have a PPC went panicking to read their own letters, but both of them are younger than me and obviously now won’t make the same mistake I did when they hit 59. Stopping automatic renewal because you are 59 is not stated on the letter, but I have found it on their website after a bit of digging. We’ll see what they come back with.

Aliforce

sheramber said:

You admit you did not read the communication that they sent you telling you the certificate would not renew.

How many prescriptions have you had since your certificate ran out?

The penalty charge If the NHS finds that you have wrongly claimed free or reduced-cost treatment, you may be guilty of an offence and you may have to pay a penalty charge. In some cases you may be prosecuted. The penalty charge is a civil fine – it is five times the amount you should have paid, up to £100. This is on top of the original charge. The NHS will take action in the civil courts if necessary. For example, (at 2023 rates) if you wrongly claim free prescriptions for two items (£19.30), you will have to pay a penalty charge of 96.50 (5 x £19.30) plus £19.30 for the actual prescription charges. If you wrongly claim free dental treatment (at 24 April 2023 rates) at the lowest rate (£25.80), you will have to pay a penalty charge of £100.00 (5 x £25.80 = £129.00 subject to a maximum of £100) plus £25.80 for the actual dental charge. You can find more information about penalty charges from the following. • www.nhsbsa.nhs.uk/nhs-penalty-charges • Phone 0300 330 9291.

Thank you so much for this breakdown of how they work out the costs. I think I can see what has happened here. In the email I have had from the NHSBSA I think they have made a mistake typing in the figures, as for the number of items I've had during the period stated the charge works out at £137.40, rather than £1377.40. They had added another 7. I hope I'm right and this has a happy ending! This scale of charge I can live with but it's made for a rather stressful 24 hours. 

born_again

Another thread here about this.

https://forums.moneysavingexpert.com/discussion/comment/75305195#Comment_75305195

ader42

I’m hope you are right about them making a mistake.

However, be warned that you will likely be fined that amount for each month. They never told me about not having a valid certificate for several months so it mounted up.

Personally my prescription is for 7 items and I accidentally had a several month period without a certificate for which I got fined about £120 each month. 

Aliforce

Well, I got an email back from the NHSBSA today and they have actually apologised for the mistake. 

“I apologise, the amount stated in our last email is incorrect.
The outstanding balance of £137.40 must be paid by the respond by date on your penalty charge notice, to avoid further action being taken.”

I really could have done without the stress, but at least it’s not a four figure fine. 

HillStreetBlues

You could complain stating how stressed you have been because of their error, you might get a reduction.
It's the kind of story some newspapers run with.

Nelliegrace

It does sound as if the letter was not as clear as it should have been, if you had to search the small print for information. It did not hit you in the eye that, this year, you had to do something different. 
The letter was for 59 year olds, to inform them that there was a change in the process of obtaining a pre-payment certificate, yet you had to ask for further information about a refund after reaching 60. 
We are not all the quickest at taking in new information, especially on some of the medications.