PBS Co-payment: What It Is and How It Affects Your Wallet

If you’ve ever picked up a prescription in Australia, you’ve probably seen a small fee at the pharmacy. That fee is the PBS co-payment – the amount you pay after the government subsidises most of the drug’s price. It’s a tiny slice of the total cost, but it can add up if you’re on several medicines.

Understanding who pays the co‑payment and when you might be exempt is the first step to keeping your health expenses low. The PBS (Pharmaceutical Benefits Scheme) covers a huge list of medicines, and the government picks up the bulk of the price. What you get left with is the co‑payment, which is set by the government and reviewed yearly.In 2025 the standard adult co‑payment is $48.75 per prescription, while concession card holders pay just $6.85. If you have a health care card, pensioner card, or a parent‑carer card, you fall into the concession group. That means a massive discount compared with paying the full price.

Who Pays the Co‑payment?

Basically, it’s you, unless you qualify for a concession. The pharmacy takes the co‑payment upfront, and the PBS reimburses the rest to the pharmacy. If you have a private health insurer, they might cover part or all of the co‑payment, depending on your policy. Some employers also offer medication benefits that can offset the fee.

People without a concession card but on a low income can apply for a Safety Net. Once your out‑of‑pocket costs cross a certain threshold in a calendar year, the PBS will waive further co‑payments for the rest of that year. That safety net is a lifesaver for chronic patients who need multiple scripts.

Ways to Reduce Your PBS Costs

First, check if you qualify for a concession card. It’s a quick online form, and approval can drop your co‑payment from $48.75 to $6.85 instantly.

Second, ask your doctor about generic equivalents. Generics are usually listed on the PBS at the same subsidy level, but they often come with a lower co‑payment because the base price is cheaper.

Third, bundle your scripts. If you need several medicines, ask if the pharmacist can combine them into one prescription when possible. Some pharmacies allow multiple drugs on a single PBS item, which can reduce the number of co‑payments you make.

Fourth, explore the PBS Safety Net. Keep track of your yearly spending and apply for the safety net when you’re close to the threshold. The website lets you calculate your current out‑of‑pocket total, so you know exactly when you’ll hit the limit.

Finally, consider private health coverage that includes medication benefits. Some policies reimburse the entire co‑payment, which effectively makes your prescription free once you meet the claim requirements.

Bottom line: the PBS co‑payment is a small, predictable fee, but knowing who pays it and how to cut it can save you a lot over time. Use your concession card, check for generics, bundle prescriptions, and keep an eye on the Safety Net. With these tricks, you’ll keep more of your cash for the things that matter.