Pharmacy Expenses Claim Process for OSHC Policy

This post is all about how international students can claim their pharmacy expenses based on their OSHC Insurance.

Before we begin, one ought to understand what is PBS?

PBS stands for “Pharmaceutical Benefits Scheme” is an Australian Government program that benefits Australians as well as visitors by subsidizing medicines to make them more affordable.

The PBS is governed by the National Health Act 1953. Details about the Minister for Health are available on the Department of Health website.

OSHC for Australia is mandatory for students to keep for the entire length of their student visa. In short, OSHC insurance is a visa-length cover. Pharmacy bills containing prescription medicines prescribed by a doctor/GP while in Australia are covered under your OSHC Health Insurance.

PBS prescriptions are always accompanied by co-payment. For now, major OSHC providers have set the minimum co-payment amount for the international students to $42.30.

If the cost of a PBS medicine falls below the general co-payment amount (under co-payment prescription), the method used to calculate the maximum general patient charge for the medicine includes an Additional Fee, an Additional Patient Charge, and any applicable price premiums.

To claim the pharmacy expenses, a student first has to pay the co-payment of $42.30 (counted towards each item in the bill) & the rest will be paid by the OSHC provider up to a maximum limit of $50 per prescribed item.

Later, the student has to contact OSHC health insurance provider to start the claim process for reimbursement. We hope that the pharmacy expenses claim process for OSHC policy will be easier to understand with the following infographic.