AIBU to be enraged about a £100 HRT fine?

[OnlyOneAdda]

Been on HRT for about 18 months ago, so have purchased HRT pre payment certificate. Each time I collect my prescriptions, I am asked to show my certificate as proof of payment.

I have just received a letter from NHS saying according to their records I have falsely claimed for a prescription and I will be fined £100. Have called them and provided my certificate number...turns out that one of the new medications my GP added six months ago isn't covered and I should have paid. The letter explicitly states that being mislead by the pharmacy is not a valid exclude.

WTAF? The pharmacy accepted it as payment. If this item wasn't eligible then they shouldn't have. If I go into a shop that doesn't accept AmEx they tell my at point of payment - they don't send me a £100 fine six months later and tell me I should have known better and used a different card.

If I've pre-paid my HRT then it should cover all fucking HRT. And if an item isn't payable by the means provided at the till then this should be flagged at point of sale!!!

Absolutely fuming 🤬 (and of course like most AIBU posts I actually just want you to agree with me 🤣 so if you think IABU then please scroll on and leave me to my menopausal rage...)

And don't get me started on the fact that men don't have to pay full stop for HRT, sanitary products etc. 🙄

Thanks for raising this, I have had a med that isn't covered by the certificate. What should I do about it? Maybe I'll pop in to the chemist and ask to pay for it retrospectively!?

@OnlyOneAdda "... turns out that one of the new medications my GP added six months ago isn't covered and I should have paid." Was this new medication still HRT or something else? If it is HRT, why doesn't your HRT certificate cover it?
ETA: I'd be pretty cheesed off too OP.

Thanks for this. Just checked and discovered testosterone gel isn’t covered.

Apparently it doesn't cover testosterone gel. Who knew (not me)

My husband had this for his inhalers! Disputed it - they initially tried to uphold it. He sent proof of when he had prescriptions and corresponding payment from bank statements. They then dropped it.

Some like intrarosa testerone gel aren’t covered

The letter I have received state unless I respond by x date I will receive a penalty notice of the prescription plus £100 fine. If you're suggesting the actual penalty notice will offer a reduction to £50 for prompt payment, good to know, but I am not exaggerating - I am taking the letter I have received at face value.

I disagree that this is the same as somebody showing a fake certificate or using somebody else's.

So pleased for you that you were happy about being fined. Don't feel the same.

I wouldn't have known either, but see @HundredMilesAnHour 's post three above yours - very helpful.

But if you've paid for a hrt pre payment and you're collecting hrt meds how would you know this isn't covered. Where would you see what's covered and what isnt ? Is this something the owner of the pre payment certificate is aware of?

Pharmacy staff take it on faith if you have a certificate or claim exemptions. They aren’t there to check eligibility.

Thank you.

GP did not mention. Exchange with pharmacy was:

Pharm "Do you have an PPC?"
Me "Yes" shows it
Pharm "thanks" hands me meds

Yes, I've just read @HundredMilesAnHour 's post - very helpful. 😊

Thank you!

Posting on app and didn't see buttons 😬 or maybe was menopausal brain fail 😂

But your solidarity and outrage are appreciated!

Exactly this. I do remember checking when I first got it. Didn't think about it between Drs and pharmacy. And still maintain that I would expect payment to be requested is it is needed.

Testosterone gel

Testosterone gel, evidentially not covered, but yes HRT.

Shit I swapped to the Utrogestan pessaries recently and they’re not on the list.

Do I just hope I got away with it and pay next time??

I really think that seeing as the HRT PPC is considered as payment by the pharmacy, then it is absolutely their responsibility to flag if you’re trying to use it for something that’s not covered!!!

The issue is that OPs prescription changed over the course of the certificate, so it all checked out when she signed up.
Must admit I'm thinking of trying to get testosterone added to my hrt, would never have occurred to me it wouldn't be covered so thanks OP 😳

They're pharmacists, not experts in NHSBSA's rules - and it is the recipient of the service that the NHSBSA will always hold accountable.

Agree. And that frankly all HRT SHOULD be covered. It's not very fair if some are paying less because their symptoms are managed by included products.

And it's ironic given brain fog / cognitive symptoms this replies on remembering to check something 🤣

I feel the same about taking the HRT tbh - sometimes I have a terrible week where I forget to take 2 or 3 times. Seems so harsh that solution to bad memory is to remember 2 capsules at night, a tablet in the morning, a patch two days a week, a squirt of gel two days a week...

I’d be away to my MP about this. Absolutely shocking that patients are supposed to know rules about what’s free and what isn’t.

Wow!

I live in Germany and HRT is covered by state health insurance (which is broadly the free at point of use healthcare - it's illegal not to be insured and health insurance is deducted from your wage if employed, covered by the state if unemployed etc ).

On the other hand birth control (pill, coil etc) is only free for under 26 year olds (in a hugely unsuccessful attempt to get 27-50 year old women to have more babies to counteract the ageing population perhaps? Birth rate is very low). So still a tax on women, just enforced on a different age group...

It’s NOT free. So there are no ‘rules about what’s free and what isn’t’.

All you need to do is check a list on the website where you buy the HRT PPC and if your HRT is on the list, you go ahead and buy the HRT PPC as it saves you quite a lot of money. If your HRT isn’t on the list, you decide if you want to buy a ‘normal’ PPC (that covers all prescription meds) or if you prefer to pay your prescription charge each time. It’s hardly brain surgery.

OP made an understandable mistake. It happens. She’s human.

Your understanding is correct OP - the cost of the prescription + £100 fine.
I advised a client when I volunteered at Citizens Advice who received six of these fines from NHSBSA due to not paying for NHS dental treatment because she was advised by the receptionist that she was eligible for free care (client had told the receptionist she was in receipt of ESA, but neglected to tell her it was NI contribution-based and not income-related - only the latter was eligible for free treatment). She would have had to pay for the treatment plus the £100 fine x 6(!) but during my investigation I discovered she should have been receiving a severe disability payment (SDP) the whole time she was in receipt of cbESA, which also made her eligible for free NHS dental treatment - phew!
This is why NHSBSA insist this is down to personal responsibility because dental receptionists, GP receptionists, pharmacists, etc., aren't experts, so it's just better to check for yourself (also, I guess, someone could lie and say they were told it was OK by these staff).
I do understand it bites though. 😢

No, don't "hope" - go back to the pharmacy and pay for it. NHSBSA are ruthless and at least when you do get a letter from them you will be able to respond with a copy of your receipt and an explanation that you, belatedly, found out the pessaries weren't covered and you went back to pay as soon as you realised.