Pharmacy includes cover for non-Pharmaceutical Benefits Scheme pharmacy items that are prescription only and prescribed by a medical practitioner.
What is the Pharmaceutical Benefit Scheme (PBS)?
The Pharmaceutical Benefit Scheme (PBS) is a Government scheme that subsidises the cost of prescription medicine. The PBS sets the amount a patient pays towards the cost of a subsidised drug. If your extras cover includes benefits for Pharmacy, we’ll pay benefits for non-PBS pharmacy items that are prescription only and prescribed by a medical practitioner as being essential to treat your condition.
Benefits we pay and don't pay
We’ll pay benefits up to a set amount per item, up to your limit. Before we’ll pay any benefits, we’ll deduct an amount equal to the non-concessional PBS co-payment.
We won’t pay any benefits where your non-PBS item costs less than the co-payment amount. Benefits are not payable for oral contraceptives (unless they’re prescribed for purposes other than contraception) or for pharmaceuticals prescribed for cosmetic purposes. No benefits are payable for items available without a prescription, herbal medicines, vitamins or any over the counter preparations. The PBS is only available to persons with Medicare eligibility and a prescription will be required for all claims.