- Is a patient entitled to the PBS if they are claiming compensation?
- Yes. All Australian residents who hold a Medicare card are entitled to pharmaceutical benefits where a PBS prescription has been written. The patient is required to pay the contribution appropriate to their level of entitlement at the time of supply.
- Can PBS medicine supplied for a compensation related injury count towards a patients PBS Safety Net threshold?
- Yes. PBS medicines supplied for a compensation related injury can count towards a PBS Safety Net threshold for the patient and/or patient’s family, in the usual way.
- If a pharmacist is billing a patient’s insurance company for PBS medicine, is the patient’s entitlement to PBS or the Safety Net affected?
- No. Provided the prescription is written and supplied as a PBS prescription it can count towards an individual or family PBS Safety Net threshold.
- Should a pharmacist change a PBS prescription to private if they know it’s for a compensation claim?
- Is a patient who is admitted to a private hospital as a compensation patient entitled to the PBS?
Yes. Patients who are admitted to a private hospital as a compensation patient are entitled to receive PBS medicine, regardless of whether the patient or the insurance company is billed or pays for the medicine.
- Do I have to write a private prescription for a compensation patient?
- No. A PBS prescription can be written provided the patient is an eligible Australian resident and holds a valid and current Medicare card. You must also ensure that the patient meets any restrictions associated with the listed medicine. If they do not meet these requirements, you must write a private prescription.
- Am I still entitled to the PBS if I am making a compensation claim?
- Yes. All Australian residents are entitled to access PBS medicine and are required to pay the contribution appropriate to their level of entitlement at the time of supply.
- Do I have to declare my compensation claim?
- No. You do not need to declare a compensation claim at the time of being prescribed or supplied with a PBS medicine.
- Can I be reimbursed the patient contribution once my compensation claim is finalised?
- Any reimbursement of the patient contribution is between you and your insurance company. You will need to contact your insurance company to discuss this further.
- If PBS medicine is supplied to me for a compensation related injury, can it count towards my PBS Safety Net threshold?
- Yes. PBS medicine supplied can count towards a PBS Safety Net threshold for you and/or your family in the usual way. More information about registering your family for the safety net.
Last updated: 19 September, 2012