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Who is entitled to subsidised medicines?

• Australian residents.
• People from countries with a reciprocal health care agreement (Belgium, Italy, New Zealand, Norway, Republic of Ireland, Finland, Malta, the Netherlands, Sweden and the United Kingdom).

Will this new system affect my entitlement?

No. Eligible people will still pay a maximum of $32.90† for most PBS medicines, or $5.30† for relevant concession cardholders. Eligible veterans and war widows/widowers pay $5.30† for RPBS medicines.

So what do I need to do?

Provide the pharmacist with your Medicare card details each time you get a prescription filled.

For your convenience, you can ask your pharmacist to keep your Medicare number on record for use on future PBS prescriptions. Remember, you will need to advise your pharmacist when you receive a new Medicare card as the number changes when your card is re-issued. The pharmacist will need to know all 11 numbers, including the number next to your name (eg 2222 44444 2 2).

Concession cardholders
(e.g. Australian Government Seniors Health Card, Pensioner Concession Card or Health Care Card)

Provide the pharmacist with your Medicare card details and your concession card number each time you have a prescription filled.

Veterans covered by the RPBS

If you are a Gold Cardholder, you need to provide your Gold Card file number only.

If you are a White Cardholder, provide your White Card file number for RPBS and your Medicare card details for PBS prescriptions.

Collecting medicines for other people

You can still collect medicines for other people — just make sure their Medicare details or veterans' file details are provided with the prescription. You will also need to provide their concession card number if they have one.

What if I don't have my number with me?

Talk to your pharmacist about the ways you can still get subsidised medicines.

What if I don't have a Medicare card?

Australian residents are entitled to subsidised medicines. There are measures in place to ensure eligible people are not disadvantaged. If you're eligible but you don't have a card, ask the pharmacist about your options.

What if I don't want to provide my Medicare number?

If you do not provide your Medicare number to the pharmacist you may be charged the full price for the medicine. You can get a refund at a Medicare office, or by completing a claim form [PDF, 129Kb] and posting it to the PBS Processing Centre, GPO Box 9826, in your capital city. You can get need to provide a refund receipt (not a cash receipt) from the pharmacist. If claiming in person, also provide your Medicare card, or concession card (if applicable). If posting your claim, quote your Medicare or DVA and concession card number (if applicable) on the claim form. You should be aware that the refund you receive may not cover the full cost of the medicine.

Veterans who do not provide their veterans' file number may not receive their medicines at the subsidised price. However, a refund may be claimed from DVA state offices or by calling 133 254*. Discuss your options with the pharmacist.

How can I be certain my Medicare number will not be used inappropriately?

The privacy and secure storage of your number is protected by law.

The Australian Government subsidises many medicines under the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS).

This means that most subsidised medicines cost the consumer a maximum of $32.90†, or $5.30† for relevant concession card holders, instead of the actual price which can be hundreds of dollars.

Australian residents and some other people are entitled to subsidised medicines under the PBS. To ensure that only eligible people receive subsidised medicines, you will need to provide your Medicare card details or veterans' card details to the pharmacist when you lodge a prescription.

YOUR ENTITLEMENT TO SUBSIDISED MEDICINES DOES NOT CHANGE.

†These figures are adjusted annually, in line with the CPI, and do not cover surcharges on some alternative brands/medicines.

More information

Ask your pharmacist or visit your local Medicare office.

1800 020 613^**
Free call number for information about the Pharmaceutical Benefits Scheme (PBS), including eligibility for subsidised medicines.

132 011^*
To check your Medicare number, change your address details, report lost or stolen cards, request a Medicare enrolment form, or obtain a replacement card.

131 450^*
Translating and Interpreting Service.

1800 552 152^**
Telephone Typewriter (TTY) free call.

Department of Health and Ageing
Department of Veterans Affairs
Pharmacy Guild of Australia

* Call charges apply.

**Call charges apply from mobile and pay phones only.

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Last updated: 19 March, 2010

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