Which benefit do we use to pay for medicine?
How we pay for prescribed medicine depends on whether you have to take medicine until you are better (acute medicine) or for an ongoing illness (chronic medicine). You always get the best cover for medicine if you collect your prescription from a pharmacy in our network as we pay for medicine at the Scheme Rate. If you visit a pharmacy that is not in our network, you may have to pay part of the cost of your medicine yourself.
Medicine you take for a short time
We first pay for your acute medicine from the money we pay into your Medical Savings Account at the beginning of the year. When this is used up, we pay for acute medicine from the General Benefit Pool until you reach the:
Once you reach one of these limits, you have to pay for medicine yourself.
Medicine you have to keep taking
If you are registered for a chronic condition on the Chronic Illness Benefit, we pay for your registered repeat medicine from this benefit.