10 conditions that qualify for free NHS items - but face £100 penalty for missing vital card

If you're caught claiming free NHS prescriptions without a valid Medical Exemption Certificate, you could face a hefty fine of up to £100. These certificates, which are the size of a credit card, grant holders access to free prescriptions and can save them hundreds of pounds annually.

But beware, if you cannot present your certificate when asked, or if it has expired, you risk incurring a penalty charge. This fine is typically five times the cost of the prescription fee you avoided, with a maximum cap of £100.

Eligibility for a Medical Exemption Certificate is limited to just 10 medical conditions:

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A permanent fistula that needs continuous surgical dressing

Hypoadrenalism

Diabetes insipidus and other forms of hypopituitarism

Diabetes mellitus, also known as type 2 diabetes

Hypoparathyroidism

Myasthenia gravis

Myxoedema or hypothyroidism, which needs thyroid hormone replacement

Epileps,y which needs continuous anticonvulsive therapy

A continuing physical disabilit,y which means you cannot go out without the help of another person

Cancer

For cancer patients, eligibility hinges on being in active treatment for cancer, its effects, or the effects of cancer treatment. : "These are the only conditions that entitle you to a medical exemption certificate. If you're not sure about the name of your condition, speak to your doctor."

Applying for a Medical Exemption Certificate is free of charge. Typically, this involves completing a form provided by your doctor and, if approved, you should receive your certificate in the post within 10 days.

These cards are generally backdated to one month prior to the receipt of the application and usually remain valid for five years. It's important to renew it before it expires.

If you claim free prescriptions and the NHS cannot verify your entitlement, they will send you an enquiry letter. You must respond within 28 days with evidence of your entitlement, for example your Medical Exemption Certificate.

However, if your card is lost or expired, proving your entitlement becomes significantly more difficult and you may receive a Penalty Charge Notice if you fail to respond promptly. At this point, you'll be required to pay the original NHS prescription charge plus an additional charge.

The NHS stated: "The penalty charge is 5 times the original amount owed, up to a maximum of £100. Once a Penalty Charge Notice has been issued, if no payment has been made within 28 days, a surcharge may be added."

Penalty charge notices can typically be contested if you have evidence that you were entitled to claim the free prescriptions or if you "think you have an exceptional reason not to pay, and can show that you did not act wrongfully or with any lack of care". This can be done .