PBS Safety Net and 60Day Prescriptions Explained

PBS Safety Net and 60-day prescriptions explained

Through the Pharmaceutical Benefits Scheme (PBS), anyone with a Medicare card can access more than 5,000 subsidised medicines.

Medicare cardholders who spend $1,647.90 on PBS medicines in a calendar year, can qualify for the

PBS Safety Net. This amount is known as the safety net threshold.

For concession cardholders the threshold is lower. They will reach the safety net when they spend more than $277.20 in a calendar year.

How does a 60-day prescription work with the PBS Safety Net?

The PBS Safety Net will continue to support Medicare cardholders and concession cardholders who spend more than the threshold amount on PBS medicines in a year.

With a 60-day prescription, the benefit for patients is that their total annual medicines cost will be spread out over a greater period because they are getting more medicine upfront, each time they have a 60-day prescription filled. This will result in a lower monthly medicines cost.

Patients that hit the threshold later in the year won’t pay more.

What is the PBS Safety Net early supply rule?

The PBS Safety Net early supply rule means that for some PBS medicines, a repeat supply of the same medicine within a specified interval will fall outside the Safety Net.

From 1 December 2023, the PBS Safety Net early supply rule for  60-day prescriptions has been extended from within 20 days, to within 50 days of a previous supply of a 60-day prescription of the same medicine or any brand of an equivalent medicine to the same person.

If the previous supply of the same medicine was not a 60-day prescription, the early supply period remains 20 days.

For more information see the  Pharmaceutical Benefits Scheme (PBS) | PBS Safety Net early supply rule - Consumer Frequently Asked Questions

Will I reach the safety net?

With a 60-day prescription, patients may save so much on their medicines that they won’t need the safety net threshold because they will not reach it. Others will reach the safety net later in the year, spreading their medicine costs out over a longer period. If patients hit the threshold later in the year, it means they have saved money throughout the year.

Concession cardholders

The safety net threshold for concession cardholders is the same as before, $277.20 per calendar year. After reaching this threshold concession cardholders will receive the rest of their prescriptions for free for the rest of the year.

Brand premiums and special patient contributions will still apply. Even if a concession cardholder reaches the threshold, they:

•   won’t have to wait until they hit the threshold to save money on medicine

•   will get help with their cost of living sooner.

Medicare cardholders who do not have a concession card

Medicare cardholders who do not have a concession card will pay for fewer prescriptions each year if they are eligible for a 60-day prescription. If they reach the PBS Safety Net ($1,647.90 in 2024), they pay the concessional rate for any remaining PBS prescriptions for the year.