In New Zealand, citizens, permanent residents or holders of a work permit for more than two consecutive years are eligible for publicly funded services. Visitors or non-residents are not eligible for funded services.
The payment for a medicine in New Zealand can fall into different categories, depending on its level of subsidy. Pharmac, a government organisation, specifies which medicines will be subsidised and at what level. These medicines are listed on the Pharmaceutical Schedule.
Fully subsidised medicines
Medicines that are fully subsidised require a co-payment or prescription charge, which is an amount that you pay towards the cost of the medicines.
- For GP or hospital prescriptions, adult New Zealanders usually pay $5 per item for fully subsidised medicines from a community pharmacy. For specialist prescriptions;
- from DHBs it's $5 per item
- from private specialists it's $15 per item.
- Prescription medicines for children under 13 years are free if the medicine is fully subsidised.
For some medicines to be funded, a special authority is applied for by your doctor (specialist or GP) according to the criteria for the particular medicine. In a special authority application, a prescriber requests a subsidy for a specific medicine for a particular person with a specified medical condition. Read more about special authority.
Partially subsidised medicines
These are medicines that are only partially subsidised or funded (they are not fully funded, unlike above). For partially subsidised medicines, you need to pay an extra part-charge. The final price you pay depends on the difference between the subsidy and the manufacturer’s price, and the size of the mark-up charged by the dispensing pharmacy.
These are medicines whose cost is not subsidised. You need to pay for the cost of the medicine in full. Medicines that are bought without a prescription, or over-the-counter (OTC) medicines, must be paid for in full.
Subsidy cards allows concessions on prescription charges. There are a few different types of subsidy cards.
Prescription subsidy card or exemption card
This subsidy is aimed at reducing costs for families and people who are prescribed a lot of medicines.
You are eligible for the subsidy once you have paid for 20 new prescription medicine items from 1 February to 31st January each year. You can reach the 20-item threshold by combining prescription items for your partner and dependent children aged from 13 up to 18 years old.
This card can be obtained through your pharmacy, and your pharmacy will keep count of your prescriptions. . If you tell your pharmacy the name of your partner and dependent family members (from 13-18 years old), they can keep track of how many items you have paid for. If you or other family members visit different pharmacies, try to keep all the prescription fee receipts, and show them to one pharmacy, so they can keep a record of your total prescription count in their system. Pharmacy systems are not all linked, so one pharmacy may not always be aware of prescriptions you get from another pharmacy.
Community Services Card (CSC)
This card is means tested based on a family's income. Any family whose income, before tax, is below the amount set by the Ministry of Health is eligible for a CSC. This card is obtained through Work and Income NZ (WINZ) or the Ministry of Social Development.
Having a CSC may lower the cost of GP visits (this depends on the GP practice) and specialist prescription charges. For example, for funded specialist items, $15 may be reduced to $5.
When you have a CSC and an exemption card, there is no charge.
This card is for New Zealand residents aged 65 or over, or people who qualify for New Zealand superannuation or a veteran’s pension. The card replaces the Super Card and the CSC. If you are eligible for CSC entitlements, the SuperGold Card will indicate that.
In brief, the prescription charges for a subsidised medicine can be summarised as:
|Subsidised medicine||Prescription from GP or hospital||Prescription from specialist
|Prescription from specialist
|Child under 13 years||Free||Free||Free|
|Non-resident or visitor||Pay in full||Pay in full||Pay in full|