Assistance provided

When a client has a Community Services Card they can get a subsidy for visits to a health practitioner outside their Primary Health Organisation (PHO), as well as reduced fees for after-hours health practitioner visits.

The current subsidy levels for each visit are:

Most enrolled children under 14 will not be charged standard health practitioner's fees - with or without a Community Services Card.

Example if a health practitioner's normal charge is $60.00 per visit, it will cost $45.00 for an adult or $40.00 for a child aged 14-17 years old.

The Community Services Card does not subsidise visits to privately funded health practitioners including specialists, osteopaths, podiatrists and dietitians.

The amount paid for prescriptions will depend on what prescription item is needed, whether it was prescribed by a publicly funded health provider or a privately funded health provider, and if the person holds a Community Services Card, Pharmaceutical Subsidy Card and/or High Use Health Card.

From 1 February 2026, prescribers can issue prescriptions for up to 12 months in some cases. Any co-payment charged is per prescription, rather than each time it is dispensed. This means clients may only have to pay for one $5.00 co-payment within a 12-month period.

Anyone getting a prescription may have to pay other pharmacy fees that are not subsidised (e.g. packaging, printing and faxing).

Fully subsidised prescription items from publicly funded health providers (including public specialists) are free for people:

• under 14 or
• holding a Community Services Card (and their dependents aged 14-17 years old) or
• 65 years or older (from 1 July 2024)

If a someone in one of the above groups is prescribed items from a publicly funded health provider, they may still have to pay a fee.

For example, if they are prescribed partially subsidised and non-subsidised prescription items. This includes clients who hold a Community Services Card, Pharmaceutical Subsidy Card and/or High Use Health Card.

Example 1 - client is not in a subsidised group

George has asthma that has been stable for 10 years. He visits a publicly funded specialist for his inhaler.

He requests to change from one of the partially subsidised inhalers to a fully subsidised inhaler. His doctor notes that both inhalers do the same thing.

At the pharmacy George pays a $5.00 co-payment for his initial inhaler as he does not fall into one of the subsidised groups, and any extra inhalers needed in that 12-month period will not have another co-payment.

Example 2 - client is in a subsidised group

Tina visits her general practitioner (GP). They prescribe her the medication she needs for her ongoing disability. The medication prescribed is fully subsidised.

At the pharmacy Tina does not have to pay anything for her medication as she has a Community Services Card.

When prescriptions are prescribed by privately funded health providers (including private specialists) there is a cost. This includes fully subsidised, partially subsidised and non-subsidised prescription items.

Prescriptions from privately funded health providers have a:

• $10.00 co-payment for people aged 14-17 years old or
• $15.00 co-payment for people aged 18 years and older

Example

Sarah has an ongoing skin condition and visits her private specialist. She is prescribed a fully subsidised prescription cream.

As Sarah is over 18 years old, she is charged a $15.00 co-payment for her medicine at the pharmacy.