hiv and medicare ineligible

HIV antiretroviral medication is affordable for most Australian residents living with HIV, because Medicare subsidises the cost of HIV medication through the Australian Pharmaceutical Benefits Scheme (PBS).  People living with HIV who are not eligible for Medicare can find it costly to access their HIV antiretroviral medication. People living with HIV who are  ineligible for Medicare have several different options to access their HIV medication in NSW.

From 1 July 2022, people with HIV who are ineligible for Medicare, will have the following alternative access options in order to receive government-funded treatment*.

Option 1: individuals will need to engage in care with a public hospital-based physician and have their medication dispensed from a hospital pharmacy. The cost of consultations and any required pathology will be covered by the hospital.

Option 2: individuals can continue to see their regular s100 prescriber but will need to have their medication dispensed from a hospital pharmacy. The cost of the consult, and any required pathology will need to be covered by the patient or practice.

Option 3: individuals will need to engage in care with a publicly funded sexual health clinic and have their medication dispensed from a hospital pharmacy. The cost of consultations, and any required pathology will be covered by the sexual health clinic.

Option 4: individuals can still need to access their medication through the self-importation scheme at their own cost.

*any additional care or medication costs associated with side effects from treatment will not be covered by this government-funded scheme.

If you’re living with HIV in NSW and need any support to understand your options or navigate this process, please call Positive Life NSW on (02) 8357 8386, 1800 245 677 (freecall) or contact@positivelife.org.au

If you’re travelling to Australia it is recommended you organise your supply of HIV medication, before you arrive in Australia. If you’re already living in Australia, you can access your medication by either importing your personal HIV medication from your home country or import it from an online chemist for your own personal use.

Our Factsheet: Getting your HIV medication without Medicare offers several different options for people living with HIV who are ineligible for Medicare to access their HIV antiretroviral medication.

pdf iconMedicare Ineligible & HIV Medication

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