What is the Pharmaceutical Benefits Scheme (PBS)?

What is the Pharmaceutical Benefits Scheme (PBS)?

The Pharmaceutical Benefits Scheme (PBS) is an Australian Government program that provides subsidised prescription medicines to residents of Australia. It's aim is to ensure Australian residents have affordable and reliable access to a wide range of necessary medicines at an affordable price.

Can I claim a pharmacy benefit from HIF?

  • A benefit can only be paid on non-Government Pharmaceutical Benefits Scheme (PBS) prescription items; if the item exceeds the PBS amount of $42.50*.
  • If the cost of the item is less than the PBS amount a benefit cannot be paid. 
  • A maximum benefit of $80.00 per script item can be claimed, up to a members annual pharmacy limit. 
  • Benefits cannot be paid on contraceptives or PBS prescriptions or over the counter items purchased with or without a prescription.
  • When submitting a claim, an official pharmacy receipt must be included which identifies the patient, the item supplied and the prescribing doctor's name. 

*PBS amounts

  • $42.50 is the co-payment for 2022.
  • $41.30 is the co-payment for 2021.
  • $41.00 is the co-payment for 2020.

HIF Health Insurance

Nobody likes to think about themselves, or their loved ones, falling ill or needing healthcare treatment. But it happens. And when it does, it’s good to know you have options. With HIF Health Insurance, we prefer to let our policies speak for themselves. Simply click “Get a Quote” and choose the right private health insurance for you.