What is the PBS?

The Pharmaceutical Benefits Scheme (PBS) helps Australians get necessary prescribed medicines at a lower cost. Instead of paying the full price, the government helps cover part of the cost through the PBS. This makes it easier for people to afford the medicines they need for most medical conditions.

The amount you pay depends on the medicine. There are specific limits for how much you may have to pay based on your situation.

The PBS is part of the Australian Government's National Medicines Policy. This policy aims to make sure people can get the medicines they need, while also considering the costs.

Can I use the PBS?

The PBS can be used by all Australian residents who hold a current Medicare card.

Overseas visitors from countries that have a reciprocal health care agreement (RHCA) with Australia can also get medicines through the PBS. This covers visitors from:

• Belgium
• Finland
• Ireland
• Italy
• Malta
• the Netherlands
• New Zealand
• Norway
• Slovenia
• Sweden
• United Kingdom

Visitors must show their passports or their RHCA card to prove they qualify when getting a prescription filled.

How much will I pay for PBS medicines?

The amount you pay for your PBS medicines depends on several factors. It is based on co-payment fees, whether you have a concession card and if you reach your safety net.

What is a PBS co-payment?

A co-payment is the money that you pay towards the cost of your medicine. The government covers the rest. The co-payment amount can vary based on your prescription and the pharmacy you choose. There is a set maximum amount for all PBS medicines.

The co-payment amount changes on 1 January each year. You can check the current patient co-payment amounts. Many PBS medicines cost much more than the co-payment.

Can I get a discount on PBS medicines with a concession card?

If you hold a concession card, you pay a reduced co-payment amount. This means you pay less for your PBS medicines.

You must hold one of the following cards:

• Commonwealth Seniors Health Card
• Veteran White, Gold or Orange Card
• Health Care Card
• Pensioner Concession Card

What is the PBS safety net?

The PBS Safety Net helps people who spend a lot of money on PBS medicines. Once you reach a spending limit, called the Safety Net threshold, the cost of your medicines will be reduced or free for the rest of the calendar year:

• General card holders only pay the reduced co-payment amount for PBS prescriptions.
• Concession card holders get PBS prescriptions for free.

You need to apply for a Safety Net Card once you reach the threshold. It covers you and your dependents, which may include:

• an individual person
• a couple
• a family with dependent children

If you combine your family's PBS amounts, you may reach the threshold sooner. You can reach the threshold sooner by combining what everyone in your family spends on PBS medicines.

How do I show what I've spent on medicines?

To access the Safety Net, you need to keep a record of what you spend on PBS medicines. You can do this on a Prescription Record Form, which is available from:

• the Services Australia website
• a pharmacy

If you use the same pharmacy, ask them to record your spending in their system.

If you use more than one pharmacy, ask for a prescription record form. This will help you keep track of how much you spend.

Ask for a form the first time you buy PBS medicine in a new year. Bring it with you each time you have a script filled. The pharmacist will record the cost you pay on the form. You can also ask the pharmacies you use to print a record of your total spending at any time.

How do I save costs when taking a high dose of PBS medicine?

If you need a high dose of a PBS medicine, there are ways to save on costs. For certain illnesses or groups of people, an 'authority' script may be needed. This means your doctor will need to either:

• call Medicare
• use a special code on the prescription to approve it

An authority script allows you to pay the same as for a standard dose, even if you're prescribed a higher dose. Speak to your doctor to check if you qualify for this.

You take an authority script to your pharmacist, just like any other script. Without this script, you won't be able to get a discount.

How do I save costs with a 60-day prescription?

Some PBS medicines are available on a 60-day prescription. This means you may be able to get twice the amount of medicine for the price of one prescription.

To qualify for a 60-day prescription you must:

• live with a long-term (chronic) health condition
• be stable on your current medicine
• have talked about your medicine with your doctor
• have been given a new 60-day prescription

Your doctor will decide whether you get a 30- or 60-day prescription. Payments still count towards your PBS Safety Net. However, it may take longer for you to reach your PBS Safety Net threshold.

You can view the list of medicines that you can get on a 60-day prescription.

How do I reduce the amount spent on brand premiums?

You can reduce the cost of brand premiums by choosing a less expensive version, like generic medicines. These medicines are safe and work as well as premium brands.

A price premium or brand premium is an extra payment you pay to the supplier of the medicine, not to the government. It is a cost in addition to your co-payment. They don't count towards your PBS Safety Net threshold.

When more than one brand of the same medicine is available, the Government subsidises each brand equally. If you take a more expensive brand, the price difference is paid by you. The extra charge does not mean there is any difference in quality between brands.

Ask your pharmacist to give you a less expensive brand. Your doctor must agree that you can have a different brand of medicine to the one they prescribed. In some situations, your doctor may want you to have a specific brand.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

What is the early supply rule?

The PBS Safety Net early supply rule applies when you buy certain PBS medicines within less than a certain time period. If you buy certain PBS medicines too soon, it will fall outside your safety net threshold.

Here's what it means:

• If you buy a repeat supply within 20 days (or 50 days for 60-day prescriptions), the cost won't count towards your Safety Net threshold.
• The amount you pay won't be added to the total that helps you qualify for reduced or free medicines under the PBS Safety Net.
• You will still pay the regular co-payment for that supply, even if you've reached the Safety Net limit.

If you need additional or early repeat supply of a medicine, you will be told by your pharmacist if there are any Safety Net implications.

Resources and support

Healthdirect's medicines section allows you to search for medicines by brand name or active ingredient. You can find information on:

• their use
• whether
• product recalls

Pharmaceutical Benefits Scheme provides information on:

• the PBS
• medicines listed on the PBS
• PBS Safety Net early supply rule
• the Safety Net Scheme

Australian government resources:

• Department of Veterans' Affairs provides information on how to reduce medicine costs under the Safety Net Scheme.
• Department of Health and Aged Care answers frequently asked questions about 60-Day Prescriptions.
• Services Australia provides information for visitors to Australia on Reciprocal Health Care Agreements.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.

Looking for information for Aboriginal and/or Torres Islander people?

Find out about The Closing the Gap PBS co-payment (CTG) program which removes the PBS co-payment for eligible Aboriginal and/or Torres Strait Islander people.