PBS/RPBS Safety Net prescription record and application for a Safety Net card (PB240)
This form helps you track your spending on prescription medicines and apply for a PBS Safety Net card to reduce medicine costs once you reach the threshold.
When do you need this form?
You need this form when you regularly purchase prescription medicines under the PBS or RPBS and want to track your spending to become eligible for reduced costs. Once your family's annual spending on PBS medicines reaches the Safety Net threshold, you can use this form to apply for a Safety Net card that makes medicines cheaper or free for the rest of the calendar year.
What you'll need
- Medicare card number and reference number
- Department of Veterans' Affairs card number (if applicable)
- Centrelink Customer Reference Number (CRN)
- Details of family members to be covered including their card numbers and dates of birth
- Current address and postcode
Where to send it
Give this form to your pharmacist each time you purchase PBS medicines so they can record your spending. When you reach the Safety Net threshold, ask your pharmacist to issue you with a PBS Safety Net card.
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