Help Centre

Paying for medicine - OSHC

Prescription medicine is medicine that needs your doctor’s authorisation before a pharmacist can sell it to you.

If you have a policy with us, you might be covered for some of the cost of your prescription medicine.

What your policy covers

If you need to buy prescription medicine, you may be able to claim back:

  • up to $50 per prescribed medicine
  • a maximum of $300 each calendar year if you have singles cover
  • a maximum of $600 each calendar year if you have family cover (for policies purchased after 1 January 2012).

Each individual in a couple or family has the same limit as a single person ($300 per person, each calendar year), as long as the couple or family maximum benefit has not been used.

Refer to the relevant policy document for more information about what you’re covered for.

How to make a claim

Step 1

Your doctor gives you a prescription for your medicine.

Step 2

You purchase your medicine from a pharmacy and get a receipt. Make sure you ask for an itemised receipt so you have all the information needed to make your claim.

Step 3

Make your claim and submit any relevant receipts to us.

What you can’t claim

  1. Medicines that can be purchased over the counter without a prescription from a doctor
  2. Prescription medicines not included in the Pharmaceutical Benefits Scheme (PBS) list. Visit the Department of Health website to see a full list of PBS medicines
  3. Prescription medicines that cost less than the co-payment fee stated under the PBS. Visit the Department of Health website for more information.

Disclaimer: Prescription medicines are reimbursed minus the co-payment required under the PBS.  To see the full list of PBS medicines and the current co-payment fee, visit the Department of Health website.   

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