Everyone who is eligible for publicly funded health and disability services should in most circumstances pay only $5 for subsidised medicines.
All prescriptions from a public hospital, a midwife and a Family Planning Clinic are covered for $5 co-payments.
Prescriptions from the following providers are approved for $5 co-payments on subsidised medicines.
- Public hospital
- A midwife
- Family Planning Clinic
- Your GP (as long as they are part of a PHO)
- After Hours Accident and Medical Services (as long as they have a DHB or a PHO contract)
- Youth Health Clinics (as long as they have a DHB or a PHO contract)
- Dentists (only if the prescription relates to a service being provided under a DHB contract)
- Private specialists (only if the prescription relates to a service being provided under a DHB contract)
- Hospices (as long as they have a DHB contract)
- ACC-related claim
There is no co-payment on these medicines for children aged 13 and under.
Patients can check whether they are eligible for publicly funded health and disability services by referring to the Guide to eligibility.
To check if a medicine is fully subsidised, refer to the Pharmaceutical Schedule on PHARMAC’s website or ask your pharmacist or general practitioner.
DHBs have a list of eligible providers in their respective regions. Any provider/prescriber not specifically listed by a DHB as an approved provider/prescriber should be regarded as not approved.
Once patients and their families have collected 20 new prescription items in a year, they can get a Prescription Subsidy, which means they won’t have to pay any more prescription charges until 1 February the following year. Go to Prescription Subsidy scheme to find out more.