In Aotearoa New Zealand, some medicines are subsidised (funded) by the government so you pay less for them. Find out who is eligible for fully funded and partly funded medicines.
On this page, you will find the following information:
- What is the prescription subsidy scheme?
- Who is eligible for publicly funded medicines?
- What are fully subsidised medicines?
- What is special authority?
- What are partially subsidised medicines?
- What are unsubsidised medicines?
- What is a prescription subsidy card or exemption card?
- What subsidy is available with a Community Services Card (CSC)?
- What subsidy is available with a SuperGold Card?
- Summary of prescription charges
- Why do the charges for specialist prescriptions differ?
Medicines in Aotearoa New Zealand fall into categories based on their level of subsidy. This is called the prescription subsidy scheme. A subsidy is the amount funded (paid for) by the government for the medicine.
There are three categories of funding:
In Aotearoa New Zealand, if you are a citizen, permanent resident or hold a work permit for more than 2 consecutive years, you are eligible for publicly funded prescription services. Visitors or non-residents are not eligible for funded services.
Medicines that are fully subsidised (funded) still require you to make a co-payment or prescription charge. This is an amount you pay towards the cost of the medicine.
A special authority is an application process whereby a prescriber requests a subsidy for a specific medicine for a particular person with a specified medical condition. Specific criteria must be met before funding is granted. These are called special authority criteria and are meant to ensure that access to medicines is available for those who would benefit most from treatment. Once approved, the prescriber is provided with a special authority number, which must appear on the prescription to gain the subsidy.
These medicines are only partially subsidised or funded. This means you need to pay an extra part-charge on top of the amount you pay for a fully subsidised medicine. 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 medicines are not subsidised. You need to pay for the full cost of the medicine. These also include medicines that are bought without a prescription or over-the-counter (OTC) medicines.
A prescription subsidy card is aimed at reducing costs for families/whānau and people who are prescribed a lot of medicines. You are eligible for the subsidy once you have paid for 20 new subsidised prescription medicine items from 1 February to 31 January each year.
- You can reach the 20-item threshold by combining prescription items for your partner and dependent children aged from 14–18 years old.
- Most prescriptions for children under 14 years of age are free and do not count towards the total.
Where can I get a prescription subsidy card?
You can get this card through your pharmacy. Your pharmacy will keep count of your prescriptions. If you tell your pharmacy the name of your partner and dependent family/whānau members, they can keep track of how many items have been bought for them as well.
Pharmacy systems are not all linked, so one pharmacy may not always be aware of prescriptions you get from another pharmacy. If you or other family/whānau members visit different pharmacies, keep all the prescription fee receipts. Show them to one pharmacy, so they can keep a record of your total prescription count in their system.
The Community Services Card (CSC) is income dependent. It is means-tested based on your family/whānau's income. If any family/whānau member's income before tax (gross) is below the amount set by the Ministry of Health, they are eligible for a CSC. You can get this card through Work and Income NZ (WINZ) or the Ministry of Social Development (MSD).
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.
The SuperGold card is for New Zealand residents aged 65 or over, or people who qualify for New Zealand superannuation or a veteran’s pension. It replaces the Super Card and the CSC. If you are eligible for CSC entitlements, the SuperGold Card will indicate that.
Here is a summary of the prescription charges for a subsidised medicine:
|Patient category||Prescription from GP or hospital||Prescription from specialist
|Prescription from specialist
||Pay in full||Pay in full||Pay in full|
Prescription charges from specialists differ depending on whether the prescription is from a DHB specialist ($5) or a private specialist ($15). This is because providers or prescribers providing a service that is privately funded and who do not have a contract with either the Ministry of Health, a DHB or a PHO are not approved for subsidy.
Private specialists are not approved for subsidy if the prescription does not relate to a patient receiving a publicly funded service contracted by the DHB, and if the prescription is issued in the course of their private practice and relates to a private patient receiving a privately funded service. Read more about questions and answers – the standard $5 prescription medicine charge.