Pharmacy reimbursements information sheet
The TAC can pay for the reasonable cost of pharmacy expenses for the treatment of an injury or illness directly resulting from your transport accident.
Pharmacy expenses include medications purchased from a pharmacy, either by prescription or over the counter.
If your accident was before 14 February 2018, pharmacy items are subject to the medical excess
The medical excess is the cost of medical treatment you may need to reach before the TAC can start paying for your claim. If you need to reach the medical excess, the TAC will only pay for pharmacy items once you have reached it. If you haven't met the excess you can use the cost of medications you have paid for to meet this.
Please contact the TAC if you are unsure of how the medical excess applies to you.
What the TAC pays for
The TAC pays for pharmacy items that:
- Are directly related to your transport accident injuries; and
- Your doctor or dentist has recommended or prescribed; and
- Are purchased from a registered pharmacy, and not from a supermarket or other retail outlet.
The TAC funds up to the maximum dose recommended by the manufacturer (this information is usually found on the back of the packet or on the accompanying information leaflet). Large quantities of repeat medications can only be funded in exceptional cases, such as overseas travel. Prior approval from the TAC is required in these cases.
Types of medication funded by the TAC
For the TAC to provide funding, your medication must be registered on the Australian Register of Therapeutic Goods (ARTG). Items on this register have been thoroughly tested for safety and effectiveness; please speak to your Medical Practitioner if you are unsure whether your medication is registered.
Your prescription medication should, where appropriate, be prescribed in accordance with the Pharmaceutical Benefits Scheme (PBS). PBS is administered by the Federal Government to provide affordable medicine to Australians. TAC clients are entitled to medications under the PBS - you need to present your Medicare card, and Healthcare card if applicable to the dispensing pharmacist.
If you are unsure about how this applies to your medication, talk to your doctor or pharmacist.
Pharmacy items not covered by the TAC
Please note that not all pharmacy items are covered by the TAC. For example, the TAC does not pay for:
X Pharmacy items that are not related to your transport accident injuries
X Chinese, natural or herbal medicine
X many vitamins, minerals or complementary medications (to find out which ones, contact the TAC)
X Items not registered on the ARTG.
Claiming your expenses
You have two options for the TAC to cover your reasonable pharmacy expenses.
Option 1: reimbursement
If you pay for the pharmacy item yourself, the TAC can reimburse you. To arrange reimbursement, you need to complete a Pharmacy Declaration form. Please send this form to the TAC, GPO Box 2751 Melbourne VIC 3001 together with:
- fully itemised tax receipts for your pharmacy information:
- Pharmacy name and address
- Details of the medication, including:
- Full name of the medication or item (including brand name where possible)
- Date dispensed or supplied
- Status of the medication i.e. PBS (including PBS code), private or over the counter (this can be hand written)
- Quantity of the medication (for example, number of tablets)
- Strength of the medication (for example, 5mg, 50mg)*
- Form of the medication (for example, tablet, capsule, caplets)*
- Total amount charged per item*
- Total amount paid
* May not be required for non-drug pharmacy items
- for non-prescription items, a supporting letter item and how it is related to your transport accident injuries. At times the TAC may request a supporting letter from your doctor for prescription medications also
The TAC will accept original itemised tax receipts only. Facsimiles and emails will not be accepted.
When you drop off your scripts for your prescription medications, ask your Pharmacist for a dispensary computer-generated tax receipt to ensure all necessary information is included. Please note that a cash register receipt may not contain all this information.
Reimbursement will occur in line with the TAC's fee schedule. If a pharmacy charges above this rate you will be responsible for the difference in cost.
You have two years from the date you purchased the pharmacy item to claim repayment from the TAC.
Option 2: direct billing
You can ask your pharmacist to bill the TAC directly for your accident-related pharmacy items.
Restricted pharmacy items
The TAC has special policies to regulate the way some pharmacy items are used. These are outlined on the TAC website and a summary of some of these are as follows:
- Some medications, referred to as 'schedule 8 drugs', (for example morphine and pethidine) are highly addictive and can be dangerous if not taken properly. The TAC will only fund schedule 8 drugs when they are prescribed in accordance with the Pharmaceutical Benefits Scheme.
- Sedative medications such as Valium and Temaze have a high potential for harm and dependence. The TAC will only pay for a single prescription of any sedative within the first three years following an accident.
- Topical non-steroidal anti-inflammatory creams or gels, such as Voltaren gel, can be funded for a maximum of six weeks post-accident or surgery. This funding limit is based on the manufacturer's recommendation and normal clinical use.
- For certain types of pharmacy items, the TAC needs to approve funding before we can reimburse the cost of your medication. This applies when it is unclear how the item relates to your accident injuries. For example, medication to treat weight loss, medication to treat erectile dysfunction, and glucosamine may need to be discussed with the TAC.
For more information please visit our Medication page or call us on 1300 654 329.