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1.7 million NHS fines overturned

1.7 million NHS fines overturned

About 1.7 million fines wrongly handed out to people thought to be falsely claiming free NHS prescriptions or dental treatment have been overturned in England since 2014, according to the spending watchdog. Check now if you're eligible for help with healthcare costs.

Many NHS patients in England have to pay for prescriptions and dental treatment, but some – including young people and those receiving certain benefits – are exempt from these charges. 

If you make a false claim, you could be fined up to £100, as well as being charged the cost of the prescription or treatment.

But new figures from the National Audit Office show 1.7 million fines for false claims were overturned in the past five years. The majority were cancelled after it was shown that these patients were in fact eligible to claim. 

The overturned fines were worth £188 million in total, and represent 30% of the total number of fines issued since 2014. 

See our Cheap & Free Prescriptions guide for more help cutting costs.

How much do prescriptions and dental care cost?

Prescriptions currently cost £9 each in England, although you could save by buying a prescription prepayment certificate if you get at least one prescription a month. Prescriptions are free in Scotland, Wales and Northern Ireland. 

NHS dental charges in England cost between £22.70 and £269.30, depending on the treatment.  

If you have a low income, you may also be able to get help with these costs from the NHS Low Income Scheme. This can also help with costs for eyecare (such as sight tests and glasses), wigs and fabric supports, and the cost of travelling to receive NHS treatment.

Am I eligible for free prescriptions or dental treatment?

You can claim free prescriptions and dental treatment if you're:

  • Under a certain age. If you're claiming free prescriptions, you'll need to be under 16, or under 18 and in full-time education. 

    If you're claiming free dental care, you'll need to be under 18, or under 19 and in full-time education.

  • Pregnant or have had a baby in the last 12 months. You'll need a valid maternity exemption certificate (MatEx) to claim, which you can apply for through your doctor, midwife or health visitor.

  • An NHS inpatient. If you're getting free dental care, this will need to be carried out by the hospital dentist. 

You could also be eligible to claim free prescriptions and dental treatment if you or your partner receive certain benefits, or if you're under 20 and are the dependant of someone who receives them. These are:

  • Universal credit, as long as you meet certain criteria.
  • Income support.
  • Income-based jobseeker's allowance.
  • Income-related employment and support allowance.
  • The guarantee element of pension credit.

If you don't meet the criteria above, you could still claim free prescriptions (but not free dental care) if you:

  • Are aged 60 or over.
  • Have a valid medical exemption certificate. You could be eligible for a medical exemption certificate (MedEx) if you have certain medical conditions or a continuing physical disability which means you can't go out without help. You can get an application form from your doctor – the NHS website has a full list of conditions which qualify you for a MedEx. 

  • Have a valid war pension exemption certificate, as long as the prescription you're claiming is for your accepted disability. 

How do I claim?

When you collect your prescription, you can tick a box on the back saying you don't need to pay. You may be asked for proof, such as an exemption certificate.

If you're claiming free NHS dental treatment, you'll be given a form at the dentist and can tick a box saying you're exempt from charges. Again, you may be asked for proof of your entitlement.  

Remember that it's your responsibility to know whether you're exempt from these charges – it's not up to your dentist or pharmacist. 

If you're not sure whether you're exempt or not, you should pay the charges upfront and apply for a refund later once you've established you are exempt. 

You'll need to use an HC5(D) form to apply for a refund for dental charges, or an FP57 form for prescription charges – you'll need to ask for the FP57 form when you pay for your prescription, as you won't be able to get it later. 

I've been given a fine – what can I do?

If you think you've been wrongly given a penalty charge notice (PCN), you can challenge it. 

You can do this on the NHS Business Services Authority's website – you'll need the reference number on your PCN letter, as well as your date of birth and the amount you've been fined.

You can challenge your fine if you do have a valid entitlement to claim free prescriptions or free or reduced dental treatment. You can also make a challenge if you think you have an exceptional reason not to pay, and can show you "did not act wrongfully or with any lack of care".

What does the NHS Business Services Authority say?

The NHS Business Services Authority, which handed out the fines, said: "The rules around entitlement, which are set by [the Department of Health and Social Care], can be complicated to understand and we recognise that genuine mistakes and confusion happen.

"We strongly believe in educating patients and ultimately removing error, so we can efficiently tackle deliberate fraud, which is why in conjunction with NHS England we invested £1.6 million in a national campaign to educate patients about eligibility.

"We acknowledge that understanding eligibility can be even more difficult for vulnerable people and so we have invested a lot of time and effort into creating extra support."