39Pharmaceutical Reimbursement Calculator

39  Pharmaceutical Reimbursement Calculator

 (1) The pharmaceutical reimbursement for an Eligible Person is worked out as follows:

  Step 1 add the co‑payments for the Pharmaceutical benefits incurred by the person in the previous calendar year (sum of co‑payments) up to the threshold of payments according to the safety net and disregarding any uncounted co‑payment.

  Step 2 compare the sum of co‑payments with the sum of the pharmaceutical allowance component of the MRCA supplement, pension supplement, veterans supplement and war widow/war widower pension payable to the person in respect of the previous calendar year.

  Step 3 if the sum of co‑payments (amount 1) exceeds the sum of the pharmaceutical allowance component of the MRCA supplement, pension supplement, veterans supplement and war widow/war widower pension payable (amount 2), the amount by which amount 1 exceeds amount 2 is the pharmaceutical reimbursement for the person.

Note: the amount of any of these supplements may be zero.

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  For the Pharmaceutical Reimbursement Calculator an uncounted co‑payment is a co‑payment for a Pharmaceutical benefit where the co‑payment is not counted for the purposes of the safety net applying to the person.

Note: included here are co‑payments for Pharmaceutical benefits dispensed under the “Safety Net 20 Day Rule” (subsection 84C(4AA)) of the National Health Act 1953.