What is the Pharmaceutical Benefits Scheme (PBS)?
A. The PBS is a Commonwealth Government initiative that provides affordable access for all Australian residents to effective and cost – effective medicines. Around 80 percent of prescriptions dispensed in Australia are subsidised under the PBS. From 1 January 2008, you pay up to $31.30* for most PBS medicines, or $5.00* if you have a concession card. The Commonwealth Government pays the remaining cost. For more information go to About the PBS. *Under current arrangements, these amounts are adjusted in line with inflation on 1 January each year.
The Pharmaceutical Benefits Scheme (PBS) is a Government scheme which helps pay for pharmaceutical items. Non-PBS drugs are those that are not listed under the scheme. If your doctor prescribes drugs that are not covered by the PBS but are approved by the Therapeutic Goods Administration (TGA) and are on the HCF approved list, you can claim a benefit for the difference between the actual cost of the item and the maximum PBS specified charge. HCF will pay up to the cost in excess of the current PBS fee for all HCF approved non-PBS drugs. The maximum is $50 per drug, up to a limit of $500 per person per calendar year. The Gap Understanding the Gap HCF has an extensive network of service providers and private hospitals throughout Australia, where specific charges have been negotiated for your benefit. Medical Gap The Australian Government subsidises medical services listed on the Medicare Benefit Schedule (MBS). However, when a doctor charges a fee higher than the MBS, it’s referred to as
• Many medications cost much more than what you actually pay. The Australian Government provides a subsidy for many essential and commonly used medicines, so that you pay less. The PBS Schedule lists all medicines that are available at the Government-subsidised price. For more information on the Pharmaceutical Benefits Scheme visit the Department of Health and Ageing.