What is PBS?

The PBS Schedule lists all of the medicines available to be dispensed to patients at a Government-subsidised price. The Schedule is part of the wider Pharmaceutical Benefits Scheme managed by the Department of Health and Ageing and administered by Medicare Australia.

Who is eligible for the PBS?

The Scheme is available to all Australian residents who hold a current Medicare card. Overseas visitors from countries with which Australia has a Reciprocal Health Care Agreement (RHCA) are also eligible to access the Scheme. Only those eligible for the PBS will receive subsidised medication and every time you present your script to the pharmacist, you will need to provide your Medicare card. Eligible veterans may need to present their DVA card in addition to their Medicare card. With your consent, the pharmacist may (at their discretion) keep a record of your Medicare number so that you do not have to show the actual card every time you lodge a script.

Who is eligible for a concession?

To be eligible for a concessional benefit, you will have one of the following concession cards:

■ Pensioner Concession Card;

■ Australian Seniors Health Card;

■ Health Care Card; or

■ DVA White, Gold, or Orange Card.

Some State / Territory governments issue Seniors Cards. These are not considered concession cards for the purposes of the PBS.
Centrelink is responsible for the issue and administration of the Pensioner Concession Card, the Australian Seniors Health Card and Health Care Cards.
DVA are responsible for White, Gold and Orange Cards.
There is also a DVA Pension Card, which entitles holders to PBS medicines at the concessional rate (but not RPBS medicines).
General benefits apply if you do not have any of the above cards

What is the PBS Safety Net?

If you or your family need a lot of medicine in a calendar year, the PBS Safety Net helps you with the cost of your medicine. Once you or your family reach a Safety Net threshold, you can apply for a PBS Safety Net card - your PBS medicine will be less expensive or free† for the rest of the calendar year.

† If you choose a more expensive brand of medicine, or if your doctor prescribes one, the extra amount you pay won't count towards your PBS Safety Net.

What do I need to do?

You need to keep a record of your PBS medicine on a Prescription Record Form (PRF), which you can get from your pharmacy. Each time you have a PBS medicine supplied, hand your form to the pharmacist so it can be recorded. Your pharmacy might be able to keep a record for you on their computer, but if they can't or if you visit different pharmacies, its best to keep your own records. If you have a family, ask your pharmacist about combining the amounts you spend for your Safety Net total.

What happens once I reach the Safety Net threshold?

When you are close to reaching the Safety Net threshold, ask your pharmacist about how you can apply for a Safety Net card. Once you have reached your relevant threshold and your pharmacist has issued your Safety Net card, medicine will be less expensive or free† for the rest of the calendar year.

PBS Safety Net thresholds from 1 January 2012

When you are close to reaching the Safety Net threshold, ask your pharmacist about how you can apply for a Safety Net card.

If you get a PBS medicine within 20 days of a previous supply of the same medicine, the cost may not count towards your Safety Net threshold. Even if you have already reached the Safety Net you may have to pay your pre-safety net amount.

For further information about the PBS Safety Net 20 days please come in store and see your pharmacist rather than the Department of Health and Aging.

How much will I pay for my PBS medicine from 1 January 2012?

* If you have a Department of Veterans' Affairs (DVA) White Card for specific conditions and your medication is for those conditions you will pay $5.80, otherwise you pay the general amount.

NOTE: If you choose a more expensive brand of medicine, or if your doctor prescribes one, the extra amount you pay won't count towards your PBS Safety Net..

What if I've received a non PBS prescription?

Your doctor might give you a prescription for a medicine that isn't available on the PBS, or isn't available on the PBS for your specific condition––sometimes called a 'private prescription'. Your doctor will indicate this on your prescription and you will need to pay the full price for the medicine at the pharmacy. The cost of these prescriptions does not count towards your PBS Safety Net.

Changes affecting same sex partners

In the past, same sex couples could not access the Medicare or Pharmaceutical Benefits Scheme (PBS) Safety Nets as a family.

Amendments to the Health Insurance Act 1973 will allow same sex partners and their dependent children to register as a family for the purposes of the Medicare Safety Nets. Amendments to the National Health Act 1953 will allow same sex partners and their dependent children to access the PBS Safety Net as a family.

Where can I find more information?

General information: PBS information on:
health.gov.au site

PBS and Medicare Australia:
PBS information on medicareaustralia.gov.au site

The Safety Net: Safety Net information on:
medicareaustralia.gov.au site