The cost of health

Are you eligible for pharmaceutical assistance? It’s very likely the answer is “yes”

pills-26621_1280One of the greatest benefits of being an Australian citizen is our ace healthcare system. I personally know people who moved to our shores for this specific reason, as their native systems only offer a seriously sick person two choices: go bankrupt paying for treatment, or die. Medicare isn’t perfect, sure, but Australia’s healthcare system is ranked number 32 out of this planet’s 190 nations (fact: do NOT get sick in Myanmar).

One of the cornerstones of our strong healthcare system is the Pharmaceutical Benefits Scheme (the PBS), which is structured to provide discounts on essential medications for people on pensions and other Centrelink payments, such as NewStart Allowance. The PBS provides access to more than 2,600 prescription medications at a much, much lower cost. To make things even better, Pharmaceutical Allowance is an extra $6.20 that is given to people on the pension each fortnight in order to cover the price of meds under the PBS, and is usually automatically included with the main payment as standard. Sure, $6.20 doesn’t sound like an earth-shattering torrent of currency, but keep in mind that if you have a Pensioner Concession Card then filling a standard script for any medication listed on the Pharmaceutical Benefits Scheme is $5.90.

But are you personally eligible for cheap pills under the PBS? The answer is probably “YES” if you are receiving a:

  • Sickness Allowance
  • Parenting Payment
  • Disability Support Pension
  • ABSTUDY, NewStart Allowance, a Special Benefit or Widow Allowance, or even Youth Allowance if you have a temporary illness or medical condition, or are a single person who is the main carer of a dependent child

Remember, though, if you are unable to produce a Concession Card when you pay for your meds, pharmacists have no obligation to give you the PBS discount and things may get VERY expensive, as in ten times the normal cost (or more). In this situation, just ask your pharmacist for an official PBS refund receipt, which can be used to (surprise) get an appropriate refund at a future date.

All Australians are eligible for a Medicare card despite what benefits they’re on or how many hours they work each week. Due to the number of different payments and benefits available across NSW, we’ll go into greater detail about this below.

People on the pension

The pension, no matter whether you’re getting it for a disability, in relation to your age or other reasons, provides many positive aspects beyond actual cash, such as the right to travel on public transport for only $2.50 a day, assorted discounts and, of course, access to the Pharmaceutical Benefits Scheme. As just about every person on the pension will require some form of medication, whether it be to treat a mental health issue, a physical injury or a disease, people on the pension will automatically receive a small payment to cover these costs. In addition, people on the pension may use their concession card to get any item on the PBS list for $5.90.

NewStart Allowance

People on NewStart don’t get a Pensioner Concession Card because they aren’t on the pension. They may, however, be eligible for a Health Care Card, which is very similar to how a Pensioner Concession Card operates, but only for health-related discounts. Don’t expect to get a cheap movie ticket by flashing one.

People employed in part-time work for award wage

Since the 1st of July, 2005, people on the Disability Support Pension have been allowed to work up to 30 hours a week without affecting their eligibility to receive the DSP, and they have also retained their right to discount medications under the Pharmaceutical Benefits Scheme. Working beyond 30 hours a week at award wage means you will very likely lose your Pensioner Concession Card, as well as all of its associated discounts.

People employed in full-time work for award wage

Well, first of all, I just want to say congratulations: you’ve broken free of Government benefits altogether, and you deserve a high-five for pushing yourself to achieve total independence. The bad news is now you’ll have to pay the standard price for all your meds, which can be a real pain. There are many factors at play here, such as how long you were on benefits before rejoining the workforce, but no matter what, you should still be eligible to get a Medicare card.

Employed part-time or full-time, but also clased as being on a low-income

You may be eligible for a Low-Income Health Care Card. You can easily claim this online (or complete physical paperwork, if you’re a Luddite). Be assured that you won’t get punished for being tough enough to get out there and slog for a living, especially for below-award wages.

People with a chronic medical condition

This isn’t America; we take care of people who are sick and even provide a financial Safety Net in case their essential, life-saving medicines would put them in the poor house. Just focus on getting better and rest assured that you won’t become a cash-cow for greedy doctors.

A tip you can take to the bank

Paying too much for your current brand of pill? You can ask your prescribing doctor to put you on a cheaper brand of medicine. There are many near-identical meds known as “generics” that do exactly the same thing as their more expensive cousins. Generics have identical active ingredients to what you’re already using, but are lower in price. Remember that all the medications you see on the shelves must meet the Therapeutic Goods Administration’s standard of quality, so there’s nothing inferior about choosing generics. The only differences are cosmetic, such as shape, colour and size. This is purely a case of “paying for the name.”

old-523086_1920Thanks for the tip! Now I can afford lessons on how to iPod my Facebook

Don’t panic!

If things get really tough you can choose to fall into the PBS Safety Net. To prevent you and your family going broke simply because you need to buy enormous amounts of medication, the PBS Safety Net is in place to ensure your medical bills don’t become insurmountable.

The three rules of psychiatric medication

  • Don’t take a higher dose than what your doctor has prescribed, especially if it’s a psychiatric medication. What you’ve been prescribed is specifically worked out by a medical expert based on numerous factors, and doubling up (or worse) won’t make the pills work any better. In fact, you may damage your kidneys, overdose, or inflict other unwanted horrors on yourself in the process. On the subject of dosage levels, don’t take LESS than what you’ve been prescribed, either, or you may not get the intended benefits.
  • Do not stockpile, resell or give your prescription medications to anybody else. It’s a criminal offense, and somebody could get seriously sick.
  • Finally, you should NEVER get high on psychiatric medications. Brain damage, psychosis and all sorts of awful things can happen. After all, these pills are designed to affect your brain chemistry. They are serious, heavy duty meds and you have to take them responsibly.

Further reading and information

www.humanservices.gov.au

www.healthdirect.gov.au

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