Pharmaceutical prescriptions claiming
Discover how to claim for pharmaceutical prescriptions to make sure you get the most out of your benefits.
What pharmaceutical prescriptions can you claim?
If your Extras, opens in a new tab cover includes Pharmaceutical Prescriptions, we’ll pay benefits for items that are not part of the Pharmaceutical Benefits Scheme, opens in a new tab (PBS).
The amount you get back will depend on your level of cover.
We may provide a payment for pharmaceutical prescriptions if the following conditions are met:
The drug is dispensed by a registered pharmacy in private practice or by a doctor
The drug is only available on prescription
The drug is not listed in the PBS, or is listed on the PBS but used for an indication not recognised by the PBS
The drug is listed within the Poisons Standard as S4 or S8
The drug is registered on the Australian Register of Therapeutic Goods (ARTG) (excluding Export Only medication under the Therapeutic Goods Act 1989)
For compounded drugs, at least one component must meet the above conditions
How to claim for pharmaceutical prescriptions
- How to claim
- What can’t you claim?
Please inform your pharmacist when submitting your prescription that you’ll need a receipt for health fund claiming, as standard receipts may not meet the required criteria. Receipts from your local grocery store can’t be used to make a claim.
Your receipt must include:
Script number
Dispensed date and description of each medication
Individual charge of each medication
Full name of the person who received the medication
Full name and street address of pharmacist
Details of payment.
Now that you have your receipt, follow our claiming guide.
Pharmaceutical Benefits Scheme
Learn how to better understand the Pharmaceutical Benefits Scheme (PBS).
Submit a claim
Haven’t claimed for your treatment or service? Find out how you can claim online.