Can NHS prescription penalty charges be appealed- Universal Credit?

[Ann2054]

Hi,
I'm a single parent with one child and receive Universal Credit. Recently I started working more hours and now earn around £1,600–£1,900 per month.
What I didn't realise is that there is a cut-off point for free NHS prescriptions once your earnings increase. Had I known, I would have happily paid for them. I've been a single parent for 16 years and have always qualified for free prescriptions, so it never even crossed my mind that I might no longer be entitled. I also hardly ever get prescriptions – maybe once a year. But in Feb I took few.
A few weeks ago I received a Penalty Charge Notice for an NHS prescription. The prescription itself was £9.90, but the penalty was £49.50, making the total £59.40. The letter didn't even explain which prescription it related to. I paid it anyway.
Today I've received a second Penalty Charge Notice for another £59.40 relating to prescriptions from February/March 2026.
What frustrates me is that nothing was ever communicated to me about losing entitlement to free prescriptions. I understand that ultimately it's my responsibility to check, and I'm not trying to avoid paying for prescriptions I wasn't entitled to. But it feels harsh to go straight to penalties without any warning or notification that my circumstances meant I was no longer eligible.
Has anybody successfully challenged these penalties on the basis that nothing was communicated to them about losing entitlement? Has anyone appealed and had the penalty reduced or waived where it was clearly an honest mistake?
And before anyone says "you should have checked" – yes, I know. Save yourself the effort and go shout at a wall instead 😉.

Sorry this has happened, in an ideal world they would let you know… but how do they (the pharmacy) know what you earn etc to tell you to pay instead? I’ve heard a pharmacist say to a person if you aren’t sure, pay it and then they give them the forms to claim it back if it turns out they are entitled to it for free.

I think even if you are entitled to them for free but you tick the wrong box you can still get a fine (although not sure if you could appeal that) so the likelihood of being able to appeal because you didn’t check when your circumstances changed are pretty slim. However, if there’s an appeals process on the letter, it’s worth a try. If you had more prescriptions that you think more fines will be coming for, you could try letting them know and offering to pay the costs now so they don’t have to issue a fine to you. I don’t know if that’s possible.

it’s an expensive lesson to learn, and because of how long it takes to come through, you could have been claiming for months in theory, which feels unfair if you were to get lots of fines as a result. But I suppose the point of it is to make it not worth the risk to people to try it.

Ultimately, you can’t prove that you genuinely thought you were still entitled to claim free prescriptions and not someone who thought they’d try their luck. Another person in your position may have been fully aware, but thought it wouldn’t get noticed because they’d qualified for so long.

At least now you know it’s your responsibility to check before signing a declaration, and you can warn friends who might be in a similar boat. I hope you can appeal and get the subsequent fines removed. You could argue that you wouldn’t have claimed again if you’d had the first fine through before needing another prescription. Good luck.

I think the problem you are going to have is that you ticked the box saying you met the criteria but didn't look into what the criteria was, and it was your 2nd fine. You may have got them to drop the penalty the 1st time, the 2nd time seems very unlikely.

I didn't know this either they don't make that well known. I means its worth a try you've got nothing to lose but I doubt it will make any difference but if it was me id still appeal it

I got fined when I was visibly pregnant for a dental appointment, because I didn’t actually have an exemption certificate. I appealed it and they took away the charge for the appointment once I proved my dates but I still kept the fine part. I would assume seeing as you are actually not exempt you would not be able to appeal.

They're really ruthess, I got charges in similar circumstances and there was no way to get out of it. Even though it was a genuine mistake on my part, I'd even checked the criteria and still fumbled it. They will payment plan it over 12 months.

I got charged as I have a medical exemption but my certificate run out. I called the people (it’ll be on the letter) and they removed one of the fines.

No it’s your responsibility to check your entitlement and it does explain your entitlement at the bottom of your UC statement.

My partner has to pay for his prescriptions and was a day past his pre payment certificate expiry when he picked them up. He has done a pre payment certificate for years!

He got a fine for about £90. They didn’t give any shit that it was a genuine mistake, even with evidence show it was literally hours after it had expired and proof that he had paid a pre payment certificate for years.

I wondered about this recently with DD prepayment, does the date of it go on the day you collect rather than the date medicine was prescribed. Ours was one day out too

Its at the bottom of every UC statement so I dont think you'd win an appeal for not knowing (I appreciate that people hardly ever read that part of the statement though)

I’ve paid multiples of these - I had an expired exemption cert and DH had been picking up and ticking boxes when he picked his prescription up.
I paid them -I think there were 6 in total - they get you on one and then keep going back to add on any others. It’s fair enough I suppose. But frustrating.

Not really related directly to this post, but how do people with limited literacy and/or mild learning difficulties navigate systems like this? Unless issues are quite severe I doubt there’s much support; if fully functioning adults get caught out like this surely many people get penalised constantly.

Working as an adviser I've had the odd one revoked in the sort of circumstance where you are but you'll only get an exception once I think.

What does the rubric on the back of the prescription form say?

Universal Credit was in payment for a helluva long time before the wording around ESA/JSA was amended to capture its conditions.

Hi, thank you for you comment. I only need to have it revoked once as I am now working full time and my Universal Credit stops this month. I never had any penalty before.
Would you share what did you write to get it cancelled please?

The two that stick in my mind were done by 'phone. There was a number on the letter from NHS (Business Services?) I rang that and explained why I thought the recipient should be cut some slack.

Everyone should check the criteria. They will issue fines.

Nobody tells you, the onus is on you to look it up. Personally I think people should be told somewhere in their claim. I don't know if they do though.

I'll be surprised if they cancel it, its information you're supposed to find out, but it's worth a shot.

How many more penalties might be coming your way? It certainly sounds worth trying to get in touch in case they can reduce the number.

Did you actually sign the forms yourself? At my local dispensary, they started signing them for you since Covid, although we use pre-pay. I have wondered what would happen if they tick the wrong box.

It's a sadly expensive lesson for those caught out to make sure you read what you sign. For anyone wondering if they might fall foul of this too, it does say on the tick box "Universal Credit and meets the criteria. Find out more at www.nhsbsa.nhs.uk/UC "