Skip to content
PREV PAGE Gym and weight management claiming

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 will get back will depend on your level of cover.

We’ll pay a Pharmaceutical Prescriptions benefit when:

  • The drug is only available on prescription; and
  • The drug is listed within the MIMS schedule as S4 or S8; and
  • The drug has not 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 they are prescribed to treat a medical condition such as skin disorder or a hormonal condition (To prove that the contraceptive is used to treat a medical condition, you will need to provide a letter from the prescribing doctor that states 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).
  • Mixed to form a compound drug where at least one ingredient is listed on the MIMS schedule. All other ingredients must be listed on either MIMS or the poisons schedule
  • 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, (make sure it’s nice and clear and doesn’t cut off any details) and submit it online or using 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.

Continue to the next page

Related articles

How to claim on the nib app

When do my health insurance annual limits reset?

Why do I need private health insurance?