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Pharmaceutical prescriptions claiming

If your Extras cover includes Pharmaceutical Prescriptions, we’ll pay benefits for items that are not part of the Pharmaceutical Benefits Scheme. The amount you get back will depend on your level of cover.

We’ll pay a Pharmaceutical Prescriptions benefit when all of the following applies:

  • The drug is only available on prescription

  • The drug is listed within the MIMS schedule as S4 or S8

  • The drug hasn't been claimed through the Schedule of Pharmaceutical Benefits

Is there anything I can’t claim on?

You cannot claim on pharmaceutical prescriptions that are:

  • Listed as contraceptive, unless prescribed to treat a medical condition such as a skin disorder or a hormonal condition (you'll need to provide a letter from the prescribing doctor stating the contraceptive is being used to treat a medical condition, and that medical condition must be listed in MIMS as a condition that the drug is used to treat).

  • For compound medications, at least one component must be only available on prescription; and not listed in the Schedule of Pharmaceutical Benefits (PBS), or listed on the PBS but used for an indication that is not recognised by the PBS; and published within the Poisons Standard as S4 or S8.

  • Used as part of your hospital stay (however, these may be claimable under your hospital cover).

How do I make a claim?

To make a claim, scan or take a photo of your receipt from the pharmacy, making sure clear and doesn’t cut off any details, and submit it online or in the nib App. Receipts from your local grocery store can’t be used to make a claim.

Your receipt must include:

  • Script number

  • Dispensed date and description of each medication

  • Individual charge of each medication

  • Full name of the person who received the medication

  • Full name and street address of pharmacist

  • Details of payment

For more information, refer to our Policy Booklet or contact us.

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