Prescription codes

PRIVATE: Private prescription. No government subsidy, with the customer to pay full cost of medication. Anyone with a prescription may pay this price. Some prescriptions are not subsidised by the government, and the patient pays the full cost of the medication. These products do not count towards the Safety Net total for the year but may be able to claim against Private Health Insurance. Receipts will be provided for any products that may be claimed. Under certain circumstances PBS medicines may not be subsidised by the government and in this situation, the Private price will have to be paid by the patient.

 

PBS: Price that is set by the government on the National Health Scheme. PRF stickers are provided and can be recorded on Safety Net Card. (A) - When this appears after a prescription an authority is required from the government for the PBS price. For more information on PBS click here

 

CONCESSION: Entitlement cards only (i.e. pensioners, health care cards, veteran affairs cards, CN cards (safety net cards). In order to validate entitlement a photocopy of the original card must be supplied with patient’s first order. These cardholders will pay $6.30 for most PBS prescriptions. Small government surcharges may occur in more expensive brands but can be avoided by selecting the generic equivalent when prompted. Where no price appears in benefit card field, private prices will apply.

 

SAFETY NET: Cards only (i.e. safety net cards issued for entitlement card holders on reaching safety net limits set by the government). Patients eligible for SN cards will not be charged for PBS prescriptions (unless government surcharges apply). These patients will not be charged for postage or handling where SN prescriptions are included in their orders. When the item is not a PBS prescription, private prices will apply.See Safety Net as follows:


If you and your family require large amounts of National Health Scheme prescriptions in any one-year, a Safety Net threshold exists to protect you financially. Once this threshold is reached you can apply for a Safety Net card enabling you to receive PBS prescriptions at cheaper or no cost. A family can include:

A spouse or de facto spouse

Children under 16 in your care; and

Full-time dependent students under 25

To be eligible for the Safety Net, you must keep a total of your PBS prescription expenditure. As individual pharmacies are not linked, records are only kept for prescriptions dispensed in each pharmacy. At Pharmacy Direct we will keep records of all PBS prescriptions dispensed by us for Safety Net purposes. If you use different pharmacies (including hospital pharmacies) you should keep your own prescription record form.

Safety Net Threshold


The levels for 2016 are:
General Patients: $1,494.90*- a safety net card will be issued allowing PBS prescriptions to be charged at $6.30* each for the rest of the calendar year
Concession Card Holders (pensions, health care card, veteran affairs etc) $378.00* - a safety net card will be issued allowing PBS prescriptions to be free* for the rest of the calendar year.

*These figures are adjusted annually and do not include a surcharge for the more expensive alternative brands/medicines.

If you require more information about Australia's Pharmaceutical Benefits Scheme:

Phone: 1800 020 613
Email pbs.enq@hic.gov.au
Website: http://www.hic.gov.au