A guide to Medicare and the PBS

Hank Jongen, General Manager, Services Australia

HELLO everyone.

Services Australia is responsible for delivering payments and services for a range of government programs including Centrelink, Child Support and Medicare, Australia’s universal health care system.

One of the important services that Medicare takes care of is the Pharmaceutical Benefits Scheme, also called the PBS.

The PBS lowers the cost of prescription medicines. Under the PBS, the Australian Government subsidises the cost of medicine for most medical conditions. This means Australians can use a wide range of necessary medicines without paying full price for them.

To buy PBS medicines from a pharmacist, you’ll need a doctor’s prescription and your Medicare Card. Your pharmacist can tell you if your medicine is cheaper under the PBS.

PBS medicines are available to anyone who’s got a Medicare card, visitors from other countries we have a reciprocal healthcare agreement with, and to veterans and their families who are eligible under the Repatriation Pharmaceutical Benefits Scheme.

The amount you pay for medicine can be reduced further if you have a concession card, like the Pensioner Concession Card or the Commonwealth Seniors Health Card.

Prescriptions for concession card holders are available at the concession rate of $7.30. This rate is adjusted on 1 January each year, in line with the Consumer Price Index (CPI).

In addition to getting medicines at subsidised costs, if you still spend a lot on PBS medicines, you may reach the PBS Safety Net threshold. This means you can receive cheaper PBS medicines for the rest of the year.

The PBS Safety Net thresholds is $262.80 for concession card holders, and $1,536.50 for general patients. You need to keep a track of how much you spend on PBS medicines throughout the year. Talk to your pharmacist as they can help. Once you’ve reached the threshold you can then apply for a PBS Safety Net card to get cheaper medicines for the rest of the year. The PBS Safety Net resets on 1 January every year.

If you have the PBS Safety Net card, your medicine will either be free for concession card holders, or $7.30 for general patients.

You can reach the threshold sooner by combining what everyone in your family spends on PBS medicines. Look at our website, servicesaustralia.com.au/ pbs, to find information about how to get a PBS Safety Net card and how to combine your family’s PBS amounts.

Until next time.

Hank Jongen

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References - IOOF, The True Value of Advice research paper (2020) and Russell Investments, Value of an Advisor study (2020).

Damian Gibson