The NASUWT is aware that there are some pregnant women and new mothers in England who have been given penalty notices and demand for payment for medicines which they should have been entitled to receive for free during their pregnancy and one year after.

The Union has produced this advice and guidance to ensure that members who are pregnant or new mothers are aware of their rights and entitlements in regard to prescriptions and supported during this time.

Free prescriptions and NHS dental care

If you are pregnant or a new mother, you are eligible for free NHS prescriptions and NHS dental care, check-ups and treatment, [1] during pregnancy and for 12 months after giving birth provided you have the relevant Maternity Exemption Certificate (MATEX).

A MATEX can only be applied for and provided by someone who has access to your medical records, such as your GP, midwife or other relevant healthcare professional, e.g. a practice nurse or health visitor.

In order to do this, they may ask you to sign a Form FW8 or they may apply for your MATEX online.

Once the FW8 is complete, you should usually receive confirmation of your exemption by post within ten days, whereas you will receive confirmation of a digital certificate by email.

Your MATEX is backdated for one month from the date that the application was received. Until such time, you are still expected to pay for your prescriptions, although you can request a refund form - Form FP57 or Form FP64 for NHS dental treatment - which details how to claim a refund from your pharmacist when you pay for your prescription.

It is important to note that it does not appear possible to ask for Form FP57 later and you must ensure you apply for any refund for the period covering your MATEX within three months of paying the prescription charge.

What happens if I claim a free prescription without a Maternity Exemption Certificate?

In the absence of a MATEX, if you claim a free prescription, you could be penalised, up to £100, and be retrospectively charged for the prescriptions you have already received.

This also applies in situations where you claim a free prescription prior to the start date of your MATEX.

What can I do if I have been sent a penalty notice and have been asked to pay for my prescriptions?

In the absence of your MATEX, you will still be expected to pay for your prescriptions in order to avoid further penalties, but you can still request a refund form from your pharmacist (see above).

The NHS Business Services Authority (NHSBSA) should cancel the penalty charge/s if you pay for any free prescriptions claimed before you were issued with your MATEX.

However, the Union understands that, in circumstances where an FP57 form is not requested from your pharmacist, it is currently not possible to claim a refund of prescription charges, even when there were delays in applying for a MATEX or one was not issued to you through no fault of your own.

Nevertheless, you can write to the NHSBSA to register a complaint about the prescription charges and/or penalties you have incurred for a period in which you should have been treated as exempt.

This can be done using the NHSBSA online contact form, making it clear that you are making a complaint, or by telephoning:

  • 0300 330 1342 for Maternity Exemption Certificates; or

  • 0300 330 9291 for Prescription Exemption Checking Service - penalty charges.

You should ensure that your complaint references the following:

  • the date when you first saw your GP about your pregnancy;

  • the date of your first appointment with your midwife;

  • the date your baby is due or was born;

  • any information regarding your health and any medications prescribed during pregnancy and/or following the birth;

  • if you were asked to sign the relevant MATEX form or if your midwife or other healthcare professional told you they would apply for your MATEX;

  • the fact that you believed you were exempt, but have received a penalty notice and been asked to pay for prescriptions and that this has caused you financial hardship due to the fact that there is no process in place for claiming a refund when an exemption certificate is issued late; and

  • the fact that you are requesting a refund of the prescription charges and/or any penalty charges incurred.

If the NHSBSA refuses to refund any prescription charges and/or penalties for a period in which you would have qualified for a MATEX, you should contact your local MP and/or the Parliamentary and Health Ombudsman at [email protected]. However, it should be noted that you are expected to follow the full complaints procedure outlined above before contacting the Ombudsman.

In situations where you are unable to pay for your prescription charges, you can write to the NHSBSA requesting that the charges and penalties are waived. However, it should be recognised that you might still be charged a penalty if you do not pay for any prescriptions before your MATEX was issued.

Can I apply for help with health costs if I am on a low income?

If you are on a low income, you may be able to apply for full help or some help with health costs by applying to the Low Income Scheme once your child turns one.

Depending on your income, you may be eligible for either:

  • Certificate HC2 - which means that you qualify for free treatment; or

  • Certificate HC3 - which means that you get some help with health costs.

If you have already paid for treatment, you may be able to get some or all of the costs refunded. However, prescription charges will only be refunded if you requested Form FP57 at the time when you paid for your prescription.

To apply for a refund, you will need to complete form HC5 within three months of the treatment.

It is important to note that this only affects women in England, because prescriptions are free in Northern Ireland, Scotland and Wales.

Footnote
[1] You must be registered as an NHS patient with a dentist who provides NHS treatment in order to be eligible for free NHS dental care.

 


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