Part 5APharmaceutical Reimbursement

Part 5A—Pharmaceutical Reimbursement

Definitions: 

  In this Part:

member means an Eligible Person eligible for payment of a pharmaceutical reimbursement.

veteran means a person eligible under the Repatriation Pharmaceutical Benefits Scheme for the payment known as the “pharmaceutical reimbursement”.

33 

  The Commission may, subject to this Part, accept financial responsibility for the pharmaceutical reimbursement.

Note: if the Commission accepts financial responsibility for a cost in relation to the provision of a Pharmaceutical benefit to an Eligible Person, the Commonwealth pays that cost.

34 

  The pharmaceutical reimbursement is a financial amount that would compensate an Eligible Person for out‑of‑pocket expenses:

 (a) that the person incurred in respect of a Pharmaceutical benefit provided under this Scheme; or

 (b) that the person incurred in respect of a Pharmaceutical benefit provided other than under this Scheme but provided on or from a date when the Commission accepted liability to provide treatment to the person under the Act.

Note 1: under the Acts Interpretation Act 1901 words in the singular number (e.g. Pharmaceutical benefit) include the plural and words in the plural number include the singular.

Note 2: paragraph (b) covers what are known as “MEPIs” (Medical Expenses Privately Incurred).  Under the Act eligibility for treatment can be backdated for 3 months before a claim for pension is received and treatment costs incurred in that period e.g. co‑payments for Pharmaceutical benefits, may be met by the Department.

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  The amount of pharmaceutical reimbursement is worked out under 39.