Pharmacy and medication expenses
We’re here to help you get your life back on track after your transport accident. To help you recover we will pay for medication and other over-the-counter items provided by a registered pharmacist in Australia.
In the first 90 days after your accident, the TAC can help pay for your medication without the need for you to contact us for approval first.
When you need to contact us for approval
You or your provider need to contact the TAC for approval of your medication if:
- It is approaching or more than 90 days since your accident and we have not approved further treatment or services, or
- It has been more than 6 months since you’ve had any treatment or service paid for by the TAC.
When we can pay for pharmacy and medication expenses
In the first 90 days after your accident, if your doctor prescribes medication and other pharmacy items for your injuries, we can pay this for you without the need for you to contact us first.
After the first 90 days, you will need TAC approval for more medication.
Your doctor can provide a prescription for medication to treat your transport accident injuries and this medication will be provided by a pharmacist. You will need to give your pharmacist your TAC claim number so they can bill us directly, there's no need for you to contact us.
Other health practitioners, including optometrists and nurse practitioners, may also prescribe a limited range of medications.
We may contact your doctor and/or pharmacist to discuss your progress or request an assessment to make sure that:
- You have access to appropriate treatment and supports required for your transport accident injuries.
- You are getting proven, evidence-based treatment and not receiving treatment that isn't helping you recover.
- You are moving towards getting your life back on track or being able to live independently.
Treatment and services we can’t pay for
We can’t pay for services that:
- Do not treat your transport accident injuries.
- Are not reasonable, necessary or appropriate.
- Are not clinically justified, safe and effective.
What do pharmacists do?
A pharmacist will prepare your medication, dispense or fill your prescriptions and give you advice about the medicines you’re taking. Medication can be very important in getting your life back on track after an accident.
Medicines and pharmacy supplies can only be provided by a registered pharmacist, and can treat your transport accident injuries in a number of ways, including:
- Prescription medications
- Over-the-counter medications and pharmacy items which can be sold by a pharmacist without a prescription, e.g. dose administration aids, analgesics and laxatives, dressings, bandages, supports and syringes.
Medications may have risks associated with them. In Australia, there are systems in place to minimise these risks, including regulations on how and when certain medications are prescribed and administered. For more information please see the Pharmacy Framework and the Pharmacy Information Resources.
What we pay for
The medicines and over-the-counter items we will pay for are those:
- Required as a result of a transport accident injury.
- Requested or prescribed by a registered health professional with prescribing rights, such as a doctor/GP, dentist, nurse, midwife or optometrist, and provided by a registered pharmacist.
We can help pay for:
- Medication prescribed in accordance with the Pharmaceutical Benefits Scheme (PBS) and registered (not listed) on the Australian Register of Therapeutic Goods (ARTG), including:
- Drugs of Dependence (schedule 8 medicines), schedule 3 and schedule 4 medicines that adhere to the relevant legal requirements relating to their prescribing, dispensing and clinical use.
- Erectile dysfunction medication in oral or injectable form, up to a maximum of 8 intermittent use tablets or injections per month, or low dosage daily use tablets.
- Bacterial vaccinations (pneumococcal, meningococcal and haemophilus B) and the influenza vaccine for clients who have had a splenectomy or have a severe pulmonary condition as a result of their transport accident.
- Privately prescribed medications that are clinically appropriate for the accident-related injury or illness, where there is no readily available alternative on the PBS.
- “Off label” medication that is supported by National Health & Medical Research Council level 1 or 2 evidence.
We can help pay for over the counter items that are recommended by a medical practitioner or dentist, such as:
- Vitamins, minerals and complementary medications that are listed (as opposed to registered) on the ARTG:
- Vitamin C – in the form of ascorbic acid where required by a client with bladder complications and who is taking Hiprex as a urinary antisepsis.
- Vitamin C and iron – required by a client who has donated their own blood for use in an impending operation.
- Vitamin C and zinc – for up to 6 weeks, for a client who has poor wound healing.
- Zinc – required by a client who has a zinc deficiency as a result of the transport accident.
- Vitamin E cream – to treat scarring for up to two years post-accident.
- Glucosamine – in oral form to treat osteoarthritis affecting non-spinal joint.
- Hypericum (St John’s Wort) – to replace PBS and/or private script medications for the treatment of accident related depressive disorders.
- Vaccinium Macrocarpon (Cranberry product) – for the prevention of urinary tract infections in accident-related neuropathic bladders.
- Scar concealing products.
- Dose administration aids and the reasonable weekly refill cost.
- Topical non-steroidal anti-inflammatory drugs, such as gels, creams and sprays – for a period of six weeks, immediately after an accident or following surgery.
- Infant formula products recommended by a medical practitioner and required as a result of a transport accident injury.
- Sunscreen, where required, to counteract the effects of sun-sensitive medications or for patients with skin grafting and burn injuries.
Controlled medicines and drugs of dependence
Some medications if misused or overused have a high risk potential for harm, dependence and accidental death from poisoning. Controlled medications are subject to strict controls under the law and include medications such as sedatives and opioid analgesics.
If you have been prescribed a controlled medication, it is important that you pay close attention to any instructions from your doctor and pharmacist, to minimise the risks associated with taking a medication of this type. We encourage you to seek further information from your medical practitioner or pharmacist or see: Pharmacy Framework.
How treatments and services are paid for
We pay for your medication:
- Directly to your pharmacist, when you have given them your TAC claim number, or
- If you have to pay, use myTAC to send a copy of your receipt to us and we will repay you. Ask for a full pharmacy/dispensary receipt, which includes medication details and Medicare item numbers, and is more detailed than a cash register receipt.
We pay for your services in line with our responsibilities under the Transport Accident Act 1986.
How much we will pay
We will pay for your treatment and services according to our fee schedule. If your pharmacist charges more than the TAC rate, you may need to pay the difference.
We will pay for pharmacy and over-the-counter items in line with the Pharmaceutical Benefits Scheme (PBS) where applicable. The Pharmaceutical Benefits Scheme (PBS) provides subsidised prescription medicines to residents of Australia.
Where your pharmacist charges above the PBS rate, or the over-the-counter item is not on the PBS, you may need to pay the difference, if it's not covered by Medicare and any private health insurance.
We can also pay for the reasonable cost of private scripts dispensed by a pharmacy. If the cost of your private script exceeds our rate, you may need to pay the gap.
If your accident was before 14 February 2018, we can only pay for these services once any required medical excess has been reached. Find out if the medical excess applies to you.
If you are a provider of pharmacy services, please refer to our TAC Provider Guidelines.