Refund For Health Charges (AG)

To deal with an enquiry from a claimant who wishes to claim a refund for health charges, consider steps 1 to 8 below. The guide is presented as follows

Initial actionStep 1
Prescription chargesSteps 2 – 4
Dental treatment, sight test, glasses, travel to hospital, wigs or fabric supportsSteps 5 – 7
Non receipt of refund from PPAStep 8


clik here to return to topInitial action

1If the claimant is enquiring about
  • Prescription Charges, go to step 2
  • Dental Treatment, go to step 4
  • Sight Test, go to step 4
  • Glasses, go to step 4
  • Travel to Hospital, go to step 5
  • Wigs, go to step 5
  • Fabric Supports, go to step 5
  • Not hearing from the Prescription Pricing Authority (PPA) regarding their refund, go to step 8

clik here to return to topPrescription charges

2Inform the claimant
  • They will need to provide
  • A Working Families' Tax Credit (WFTC) / Disabled Person's Tax Credit (DPTC) Health Service Exemption Certificate
  • A NHS tax credit Exemption Certificate

Or

  • Pages 1 and 2 of the tax credit Health Service exemption form

Note: This can be a photocopy. However it must be stamped and dated by the local office / Enquiry Centre

  • They will also need to complete the following form that they can obtain from the pharmacist when their prescription is dispensed. They cannot get one later
  • Form FP57 – England
  • Form FP57 – Scotland
  • Form PS7 – Northern Ireland
  • Form WP57 – Wales
  • If the claimant does not have form FP57, PS7 or WP57, go to step 3
  • If the claimant does have form FP57, PS7 or WP57, go to step 4
3If the claimant does not have form FP57, PS7 or WP57
  • Inform the claimant they cannot get a refund

But

  • There are arrangements in place for considering refund claims where the above form is not produced, but only in exceptional circumstances
  • If the claimant thinks they had a good reason for not getting the official NHS receipt

Then

  • Inform the claimant they should submit a letter, explaining their reasons, enclosing any proof of payment, for example, a till receipt, and proof of the exemption to

Review Section
PPA
PO BOX 993
Newcastle Upon Tyne
NE99 2TZ

Note: The claimant not being aware that they should get form FP57, PS7 or WP57 is not a good reason. Form FP10 tells the claimant about the receipt

  • Take no further action
4Advise the claimant that they should follow the instructions on form FP57, PS7 or WP57 in order to claim a refund

Note: If the claimant is claiming within 3 months of the purchase, form FP57, WP57 or PS7 informs the claimant to take the relevant evidence to the post office

Note: If the claimant is claiming after 3 months of the purchase. Form FP57, WP57 or PS7 informs the claimant, that if they think there were exceptional circumstances which prevented them from claiming within the 3 months, that they should submit a letter, explaining the reasons, enclosing original receipts (and the optical prescription for glasses or contact lenses and proof of their exemption) to PPA

PO BOX 993
Newcastle Upon Tyne
NE99 2TZ

  • Take no further action

clik here to return to topDental treatment, sight test, glasses, contact lenses, travel to hospital, wigs or fabric supports

5Inform the claimant
  • They will need to provide
  • A WFTC / DPTC Health Service Exemption Certificate
  • A NHS tax credit Exemption Certificate

Or

  • Pages 1 and 2 of the tax credit Health Service exemption form

Note: This can be a photocopy. However it must be stamped and dated by the local office / Enquiry Centre

  • They will also need to complete form HC5 for dental treatment, sight test, glasses, travel to hospital, wigs or fabric support

Note: This form is available from Jobcentre Plus Offices or NHS Hospitals. Some Dentists and Opticians also stock them. Alternatively, the claimant can telephone 0845 850 11 66

And

  • They need to provide the original receipt (and the optical prescription if claiming for glasses or contact lenses)
6Advise the claimant that they should send all the above documentation to

Prescription Pricing Authority
PO Box 1011
Newcastle Upon Tyne
NE99 2ZP

Note: The PPA will authorise the form HC5 and send it to the appropriate paying body for payment

7Advise the claimant that the PPA will
  • Aim to authorise the refund application within 5 working days of receiving the relevant documents

And

  • Write to them telling them which paying body will issue their payment. Take no further action

Note: The paying body will process and issue the payment as soon as possible


clik here to return to topNon receipt of refund from PPA

8Advise the claimant that if they have sent their documents to the PPA and they have not heard anything after 15 days of posting it, they should contact the PPA on 0845 609 9299