Pharmaceutical Benefits Scheme (PBS)
Written in plain language for general understanding. This is educational content, not legal advice. Based on Commonwealth Acts of Parliament, federal regulations, and official government guidance.
What is this right?
The Pharmaceutical Benefits Scheme (PBS) subsidises the cost of most prescription medicines in Australia. It is established under Part VII of the National Health Act 1953 and administered by Services Australia.
Under the PBS, you pay a maximum co-payment for each prescription:
- General patients: up to $31.60 per prescription
- Concession card holders: up to $7.70 per prescription
If your total PBS spending in a calendar year exceeds the PBS Safety Net threshold, your costs drop further:
- General patients: once you spend $1,637.20, the co-payment drops to the concession rate for the rest of the year
- Concession card holders: once you fill 48 prescriptions (or spend $369.60), PBS medicines become free for the rest of the year
Not every medicine is on the PBS. A medicine must be assessed by the Pharmaceutical Benefits Advisory Committee (PBAC) and listed on the PBS Schedule before it can be subsidised.
When does it apply?
- You hold a valid Medicare card.
- Your doctor prescribes a medicine that is listed on the PBS Schedule.
- If you hold a Pensioner Concession Card, Health Care Card, or Commonwealth Seniors Health Card, you pay the lower concession co-payment.
What should you do?
- Present your Medicare card and any concession card at the pharmacy when filling a PBS prescription.
- Ask your pharmacist if a cheaper brand (generic) of your medicine is available on the PBS — the active ingredient is the same.
- Keep records of every PBS prescription you fill to track your progress toward the Safety Net threshold.
- Register your family as a Safety Net family through Services Australia so all family members' prescriptions count toward the same threshold.
- Request a Safety Net card once you reach the threshold — your pharmacist can help you apply.
What should you NOT do?
- Don't assume every medicine is subsidised — only medicines listed on the PBS Schedule are covered.
- Don't forget your concession card at the pharmacy — without it, you will be charged the general co-payment.
- Don't stockpile medicines — PBS rules generally limit you to one month's supply per prescription.
- Don't throw away receipts — you need them to prove your spending if applying for the Safety Net.
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