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.
On this page, you will find the following information:
- What is the prescription subsidy scheme?
- 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
The payment for a medicine in New Zealand can fall into different categories, depending on its level of subsidy. Medicines may be:
- fully subsidised
- partially subsidised
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: A charge of $5 per item applies for fully subsidised medicines from a community pharmacy.
- For specialist prescriptions from DHBs: A charge of $5 per item applies.
- For specialist prescriptions from private specialists: A charge of $5 per item applies.
Prescription medicines for children under 14 years of age are free if the medicine is fully subsidised. Once the child turns 14 years, then the prescription charges above apply.
Special Authority is an application process where for some medicines to be funded, specific criteria must be met before funding will be 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.
In a special authority application, a prescriber requests a subsidy for a specific medicine for a particular person with a specified medical condition. Once approved the prescriber is provided with a Special Authority number which must appear on the prescription to gain the subsidy.
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.
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 14 to 18 years old.
- Note: 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?
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, 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.
This card is income dependent – it 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:
|Patient category||Prescription from GP or hospital||Prescription from specialist
|Prescription from specialist
||Pay in full||Pay in full||Pay in full|