B02/1992 PHARMACEUTICAL ALLOWANCE : PROCESSING GUIDELINES, ADVANCE PAYMENTS, ADVICE LETTERS, DEATHS & BEREAVEMENT PAYMENTS AND RECOVERY

DATE OF ISSUE: 03 January 1992

PHARMACEUTICAL ALLOWANCE : PROCESSING GUIDELINES, ADVANCE PAYMENTS, ADVICE LETTERS, DEATHS & BEREAVEMENT PAYMENTS AND RECOVERY

Please note: This DI has been amended by DI No. C36/2005 issued on 17 October 2005 by revoking paras 47 and 48, and replacing them with a para 47.

INTRODUCTION

The purpose of this Instruction is to provide staff with guidelines for processing Pharmaceutical Allowance (PA) and paying advances of the allowance. This Instruction also discusses the advice letters which were sent to Repatriation Pharmaceutical Benefit Scheme (RPBS) users, details a change in policy in relation to PA and Bereavement Payments and advises staff of the guidelines to be followed when recovering overpayments of PA.

PROCESSING GUIDELINES

2.Departmental Instruction B53/91 advised staff of the changes announced in the 1991 Budget which extends the Patient Contribution and correlative PA for Personal Treatment Entitlement Card (PTEC) and Specific Treatment Entitlement Card (STEC) holders who are entitled to receive drugs under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

3.To commence payment for those veterans affected by this initiative, an automatic run took place on the weekend of 7/8 December 1991. The bulk run automatically granted PA from 26 December 1991 to Australian disability pensioners (who were not already receiving PA), and to those PTEC and STEC holders (who were not receiving any other payment from this Department), and who had provided payment details.

4.New Zealand, Hong Kong and Malaysian disability pension recipients were NOT granted PA automatically on 26 December 1991. A report was made available to the states, detailing those cases where PA has to be put into payment manually, via keyfast, using a General Purpose Coding Sheet (GPCS). These cases should have been processed by cut-off for payday 26 December 1991. It will not be necessary for the states to send an advice letter to these clients as they will have been included in the automatic advice run for all PA grants on 9 December 1991.

5.From 31 December 1991 until PA ONLY payments are linked to the Pensions Information Processing System (PIPS) on 10 February 1992, a fortnightly data extract run will identify all new cases where PTEC/STEC has been gained and no other pension is to be paid. The first report will include those cases where eligibility has been gained since 23 September 1991, when the first data collection cases were identified.

6.The fortnightly reports will detail the veteran's name, file number and treatment (BELI) type. In order to grant PA to these veterans, the following action should be taken:

a. If no BELI type is shown, the veteran's PTEC/STEC eligibility normally stems from an application for treatment/pension which has been accepted at a nil pensionable degree. For these cases, request the file and obtain the veteran's payment details from the application form. PA will then have to be put into payment manually, via keyfast, using a GPCS/D408. Normal DSS clearance procedures should be applied. Note British Disability pensioners who are paid direct by the UK (BELI type will be shown as IAS) and Australian malignant neoplasia cases will not normally have payment details recorded on file and will have to be sent a PA Payment Form in order to obtain bank account details.

b. If the BELI type is shown as TDE (POW), TFW (Treatment First World War) or TSW (SP Second World War Female Veteran), the veteran's payment details will need to be obtained and a PA Payment Form should be sent. These cases will also have to be put into payment manually, via keyfast, using a GPCS/D408 and normal DSS clearance procedures will apply.

7.Cases where SP eligibility has been lost and PTEC/STEC eligibility remains will also appear on these lists if the examiner forgot to code PA back onto the Payment Master File (PMF) manually, after cancelling SP. Appropriate action should also be taken to ensure that PA is coded onto the PMF for these cases.

8.After the bulk run to grant PA on 7/8 December 1991, it will be the responsibility of the Benefits Program to ensure that PA is granted along with all new grants of disability pension, where PA is not already in payment. PA can be processed automatically (excluding overseas DP cases which are not linked to PIPS), through PIPS on a D2650, along with DP, from Monday 9 December 1991.

9.From Monday 9 December 1991, all DP Deaths, DP Transfers In & Out and SP cancellations where DP remains in payment, can be processed automatically through PIPS, on a D2650.

10.Between 9 December 1991 and 10 February 1992 (when PA ONLY becomes available through PIPS), all new Grants, Deaths and Transfers In & Out of PA ONLY cases will have to have PA coded onto or off the PMF manually, via keyfast, using a GPCS/D408. SP cancellations or DSS Transfers where PTEC/STEC eligibility remains, will also have to have PA coded back onto the PMF manually, throughout this period. From Monday 10 February 1992, PA ONLY will be available through PIPS and these cases can be processed automatically on a D2650.

11.From 10 February 1992, all new cases with PA ONLY entitlement (i.e. accepted disabilities of nil pensionable degree, POWs etc.) will have a PIPS registration created automatically. The registration title is unknown at this stage and will be advised at a later date. Normal CMS reporting facilities will be available for monitoring the cases and it will be Benefits' responsibility to ensure that PA is put into payment for these cases.

12.Any Grants, Deaths, Transfers In & Out or cancellations of New Zealand, Hong Kong and Malaysian disability pension will have to have PA coded onto or off the PMF manually, via keyfast, using a GPCS/D410 on an indefinite basis, as both DP and PA are not linked to PIPS for these cases.ADVANCE PAYMENTS13. Departmental Instruction B53/91 of 19 November 1991 detailed the eligibility requirements for advance payments of PA for both PBS and RPBS users. This Instruction provides guidelines to staff for paying advances of PA.

Policy Issues14.If one of a partnered couple (where both partners are paid PA by DVA) has RPBS entitlement, BOTH partners will be eligible for an advance free of the income test.

15.If either one of a partnered couple (where both are receiving PA from DVA) has spent more on prescription items than he/she has received in PA, then an advance of PA can be made to the couple as if they had spent more on pharmaceuticals as a couple than they had received jointly by way of PA.16. If one partner of a couple is paid PA by DVA and the other partner is paid PA by DSS, each partner must apply to their respective Departments for an advance. The advance will normally be paid at the married rate by each Department unless they fall into the category of clients who receive PA at the single rate.

Claim Form17.An application form has been developed to enable both PBS and RPBS users to apply for an advance on the one application form. A sample of the form is at Attachment A.

18.The form places the onus on the pensioner to declare that more has been spent on prescription items than has been received by way of allowance. This declaration will be sufficient evidence of outlays on prescription items. It is envisaged that this form will only be completed over the counter with the assistance of branch office staff.

19.Pensioners do not have to complete the 'claim form' to apply for an advance. As long as a pensioner makes the required declaration in writing, a letter can be treated as an application for an advance. Should a pensioner apply for an advance by phone, he/she should be asked to confirm in writing, that they meet the relevant criteria.20. Once a claim is received in the Department it should be passed to the 'advance' examiner to determine the pensioner's eligibility for an advance. If a claim is made for an advance prior to the first pension payday in a calendar year, or, with an application for pension or treatment but prior to it being granted, the answer to question 5 of the claim form should not be requested. This is because eligibility in these cases is NOT dependent on the cost of prescription items exceeding the amount received by way of allowance.Paying Advances21. In most circumstances, advances can be paid automatically using the current advance payment system (screen PY.LP & PY.AP). Attachment B sets out the procedures for paying an advance in all circumstances, including those situations where manual action is required.

22.Advances are to be paid at 7 times the current fortnightly instalment of allowance, or, the balance of PA which is payable for the year, whichever is the lesser.

23.Because the total amount of PA paid by way of allowance and advance must NOT exceed $135.20 (single rate) or $67.60 each, (married rate) in the 1992 calendar year, the examiner must always calculate the total amount of PA that has been paid in the year, to ensure that the yearly limit is not exceeded. For example:

Single veteran has been paid 10 fortnightly instalments of PA from payday 9 January 1992 to and including payday 14 May 1992 and has also been paid 2 advance payments of $36.40 (i.e. $5.20 x 7). On 9 September 1992 he/she applies for a further advance. As a total of $124.80 has been paid so far this calendar year, the final advance must not exceed $10.40.

24.The yearly amount will be reduced if a pensioner has not had entitlement to PA for the full calendar year. The total amount payable will then be limited to the number of paydays that a pensioner is entitled to be paid PA in the calendar year, by the fortnightly rate of PA payable. For example:

Single veteran is granted PA from payday 9 July 1992. There are 13 pension paydays between 9 July 1992 and 31 December 1992. The maximum amount the veteran is entitled to receive in PA by way of allowance and advance is $67.60 (i.e. 13 x $5.20) for the period 9 July 1992 to & including 31 December 1992.

ADVICE LETTERS

25.A publicity mailout to all PTEC and STEC holders was posted on 17 December 1991. Attachment C provides details of the material to be included in this mailout. Examples of the advice letters for all affected clients have been included in Annexes 1 to 11 of Attachment C.

CANCELLATIONS, TRANSFERS OUT AND DEATHS

26.For all transfer out cases where there is an entitlement to PA, the transferring State must include a copy of the LP screen with the supporting documents when transferring the case interstate. This should be done in all cases regardless of whether an advance has been paid or not, to avoid any confusion in the transfer in State.

27.As with other transactions on the Pharmaceutical Advance screens, access to the CANCEL (CP) screen must be gained through the LIST (LP) screen. Placing a 'Y' or 'S' in the cancel field on this screen will default to the CP screen. All information on this screen will be defaulted, except for the cancel reason which the examiner will be required to complete. Reason types CANCEL, TRANSFER and DEATH will be accepted, and must be typed in full.

TRANSFERS IN

28.Details of any advances paid in the previous State should then be recorded on the advance system in the transfer in State. This can be done by placing a 'Y' or 'S' in the TRANSFER IN field of the LP screen. The system will then automatically default to the AP screen where the amount and date of any advances paid are to be recorded.

DEATHS & BEREAVEMENT PAYMENTS

29.In the past, PA has not been included in the assessment of bereavement payments. This policy is to change. From the date of this Instruction, PA is to be included in the assessment of bereavement payments for service pensioners.

30.It may be necessary to change the legislation to ensure that PA forms part of the bereavement payment. If it is necessary, the legislation will be proposed in the Autumn session of Parliament. Notwithstanding this, the above policy should be implemented immediately.

31.In the calculation of bereavement payments for service pension deaths, the survivor's PA is to be reassessed at the single rate from the date on which the deceased pensioner's payment is cancelled (i.e. from Current Reduction Date or Payday after death, whichever is applicable). This also applies for cases with SP and DP in payment. Where SP and DP are both paid, the PA component of the bereavement payment should be calculated along with SP (i.e. PA is to be paid for 7 instalments, not 6).

32.Service Pension couples who are separated due to ill- health, or where one or both are in approved respite care, receive the single rate of service pension and the single rate of PA. PA should be reduced to the married rate, from the same payday that you would normally reduce SP. PA should then be assessed at the married rate, in the bereavement payment calculation.

33.If a war widow with SP, or SP & DP in her own right dies and is survived by a spouse, the PA component of the bereavement payment should be calculated along with SP (i.e. PA is to be paid for 7 instalments, not 6).

34.Any disability pension death occurring on or after 13 December 1991, should have PA included in the assessment of the bereavement payment. The PA component will be 6 instalments of the single rate of PA. This amount is in addition to the ceiling limit of 6 instalments at 100% of the general rate.

35.If a war widow with DP in her own right dies and is survived by a spouse, the PA component of the bereavement payment should be calculated along with DP and paid for 6 instalments.

36.If a PA ONLY pensioner dies on or after 13 December 1991, a bereavement payment should be calculated if there is a surviving spouse. The survivor is entitled to receive a lump sum payment equivalent to 6 instalments of the single rate of PA.

37.As PA was updated to the PMF on 7/8 December 1991, any PA ONLY pensioner who dies prior to 13 December 1991 will have PA granted unless the date of death was recorded on the Client Data Base (CDB) prior to 7 December 1991. If this occurs, the examiner will have to cancel the PA payment before cut-off for payday 26 December 1991, to ensure that a payment is not made after death.

Effective Dates For Cancelling PA Upon Death

38.For a service pension death (single or married), cancel PA from the same payday as SP.

39.For a war widow(er) death (single or married), cancel PA from the same payday as WW.

40.For a disability pension only death (single or married), cancel PA from the same payday as DP.

41.For a service and disability pensioner death (single or married), cancel PA from the same payday as SP.

42.For a single PA ONLY death cancel PA from the payday after death. If a PA ONLY pensioner dies and is survived by a spouse, cancel PA from Current Reduction Date.

Advances

43.If a single pensioner has been paid an advance and dies before the limitation has been recovered, the balance of that limitation should be disregarded as the advance may have already been spent on prescription items. If an advance has been paid to a couple, the deceased pensioner's advance should also be disregarded. The automatic advance payment system will recover the partner's PA at the married rate until the PMF has been updated with the single rate and will continue to recover PA at this rate until PA is due to be restored onto the PMF.

RECOVERY

44.Normal overpayment and recovery guidelines are to be applied for PA EXCEPT in relation to advance payments of the allowance. If a client dies before a limitation of advance has been finalised, the balance of that limitation should be disregarded as the advance may have already been spent on prescription items. Similarly, if a pensioner ceases to be paid a pension, any advance is to be disregarded.

PART YEAR

45.Where a veteran gains RPBS eligibility part way through the calendar year, and, for the rest of that year (while remaining eligible under the RPBS) spends more on RPBS prescription items than has been received by way of PA, he/she will be out of pocket. Because it is not appropriate that a veteran be out of pocket for drugs obtained under the RPBS, procedures are being developed to reimburse any veteran in this situation. A separate instruction will be issued by the Health Program detailing the procedures for these cases.

AUSTRALIAN VETERANS RESIDING OVERSEAS

46.If an Australian veteran incurs pharmaceutical expenses for an accepted disability whilst overseas, he/she should be reimbursed for the cost of the prescription item, less the Patient Contribution. A separate instruction will be issued by the Health Program detailing the procedures for these cases.

BRITISH PENSIONERS & OTHER DOMINIONS (BP&OD)

47.It is normal practice, that when a BP&OD veterans returns overseas, he/she loses his entitlement to the RPBS. However, when a BP&OD veteran leaves the country for a short period of time only, (e.g. for a holiday), his/her RPBS entitlement remains unchanged.

48.In relation to the payment of PA, the general principle will be that if a BP&OD veteran loses entitlement to his/her STEC , PA should also be cancelled. A separate instruction will be issued detailing the procedures for these cases.

PETER HAWKER

NATIONAL PROGRAM DIRECTOR

BENEFITS

3 JANUARY 1992

ATTACHMENTS TO THIS INSTRUCTION

ATTACHMENT A

Claim for Advance of Pharmaceutical

Allowance

The information you provide on this form will be sued to process your claim for an advance of Pharmaceutical Allowance and will not be disclosed.

1.File number (if known)____________________

2.Your surname — ___________________________________

3.Given names — ___________________________________

4.Address — ___________________________________

___________________________________

Postcode

___________________________________

5.Is the sum of the amounts recorded

on your Prescription Record Form

greater than the amount of

Pharmaceutical Allowance you

received this calendar year?

Only count those items obtained

under the Repatriation

Pharmaceutical Benefits Scheme or

the concessional Pharmaceutical

Benefits SchemeNO — YES

6.Are you or your partner the holder

of an STEC (white) or PTEC

(yellow) card?NO — YES- Go to Declaration

7.Are you a War Widow or

War Widower?NO — YES- Go to Declaration

8.Is your non-pension income less

than $20.00 per fortnight (for

single service pensioners), or less

than $40.00 per fortnight (for

married service pensioners)?NO — YES

Declaration

I declare that the details provided by me in this claim are true

and correct in every detail.

I am aware that there are penalties for making false or

misleading statements.

Signature

_______________________________________/____/____

ATTACHMENT B

PROCEDURES FOR ADVANCE PAYMENTS OF PA

1. Procedures for paying an advance for 1992 for Service Pensioners, Australian Disability Pensioners, War Widows and Orphans from 20 December 1991.

- Don't pay an advance for 1992 until 20 December 1991.

- Go to PY.LP, record 'Y' or 'S' in the 'advance add' field; defaults to PY.AP

- The system will default the correct amount of advance and all relevant information for the first advance of the year.

- For any subsequent advance, calculate the total amount of PA paid by way of fortnightly instalments and advance(s) and subtract this total from $67.60 or $135.20, to work out the maximum amount that can be paid by way of advance for the remainder of the calendar year.

- If the amount of advance to be paid is less than the amount defaulted by the system, override the amount recorded in the 'advance amount' field with the correct amount.

- A cheque will automatically be produced over night and should be despatched the next day.

- The system will then automatically recover $18.20, $36.40 or the correct amount if the last advance & reinstate PA onto the PMF

- No advice is required

2. Procedures for paying an advance for 1992 for PA ONLY prior to 10 February 1992.

- This is a totally MANUAL process. At all times you must ensure that the total amount of PA paid by way of fortnightly instalments and advance(s) does not exceed $135.20.

- DO NOT pay an advance for 1992 until 23 December 1991 (being the last payday, brought forward, for 1991).

- Complete GPCS/D408 to create a manual cheque for advance and to code PA off the PMF.

- Obtain a screen dump of the PMF, for payment details.

- Record name, file number, payment details, amount of advance, payday removed from PMF and payday to be restored onto PMF, in a register. Allow space for up to 4 advances so that further advances can be recorded.

- Obtain payment details from the PA Advance Register to restore PA onto PMF.

- From 10 February 1992 (when the new system is available), record on the system details of manual advances already paid, in the following way:

- Go to PY.LP, record 'Y' in the 'transfer in' field; defaults to PY.AP.

- Go to 'advance amount' field and record the total amount of advance i.e. $36.40.

- Go to the 'advance date' field and record the date the advance was paid and press enter.

- Defaults to the LP screen with details of the date, amount of advance and total amount owed. N.B. The total amount owed will have to be amended if any amount has already been recovered.

- To amend the total amount owed, go to 'transfer in/change' field and record 'Y', press enter.

- Defaults to Transfer In/Change screen (PY.TP). Record in the 'total amount owed' field, the correct amount still to be recovered, press enter.

- The system will now automatically calculate the amount owed on an ongoing basis and when fully recovered, list the pensioner's name on a report showing those cases where PA has to be restored onto the PMF manually, by GPCS.

- No advice is required.

3. Procedures for PA ONLY advances from 10 February 1992 (i.e after PA ONLY has been linked to PIPS.

- Go to PY.LP, record 'Y' or 'S' in the 'advance add' field; defaults to PY.AP

- The system will default the correct amount of advance and all relevant information for the first advance of the year.

- For any subsequent advance, calculate the total amount of PA paid by way of fortnightly instalments and advance(s) and subtract this total from $135.20 to work out the maximum amount that can be paid by way of advance for the remainder of the calendar year.

- If the amount of advance to be paid is less than the amount defaulted by the system, override the amount recorded in the 'advance amount' field with the correct amount.

- A cheque will automatically be produced over night and should be despatched the next day.

- The system will automatically remove PA from the PMF but will NOT automatically restore PA onto the PMF.

- A report will be produced showing payment details to enable restoration of PA onto the PMF when the advance is fully recovered.

- A further report will list those cases where the advance has been fully recovered and will detail the pensioner's name and file number so that PA can to be restored onto the PMF manually, by GPCS.

- Complete GPCS to restore PA onto the PMF.

- No advice is required.

N.B. Other Dominion cases (NZ, HK and MAL) where DP is in payment will be actioned the same as PA ONLY cases as their DP is not recorded on PIPS.

ATTACHMENT C

LETTERS TO VETERANS WITH STEC OR PTEC RE PHARMACEUTICAL CHARGING OF RPBS ITEMS

As part of the introduction of charging and pharmaceutical allowance to the RPBS, a letter will be sent to all veterans with an STEC or PTEC. To ensure that the letter is as relevant as possible for the veteran, there will be ten different categories of letters as follows:

.Category 1. Those STEC and PTEC holders who receive no pension from DVA,

.Category 2. Those veterans with Disability Pension but no war widow/ers or service pension;

.Category 3. Veterans who have an STEC or PTEC and are single service pensioners;

.Category 4. Married service pension couples where one or both have an STEC or PTEC;

.Category 5. As for category 4, but the couple are an illness separated couple on single rate service pension;

.Category 6. War widows or widowers who are veterans in their own right and have an STEC. (Note, if they do have an accepted disability they are issued with a yellow card, which is embossed "War Widow". They don't get the lilac card (the DTEC, and even if they only have one AD they don't get a white card, they get the yellow card;

.Category 7. Couples where a service pensioner is married to a war widow/er who is not a service pensioner;

.Category 8. Couples where only one is a service pensioner, while the partner is neither war widow/er nor DP only (for example a blinded SP veteran married to a working wife);

.Category 9. Veteran service pensioners with STEC or PTEC who live overseas; and

.Category 10. Veterans with DP only who live overseas.

2. Categories one to eight inclusive were produced automatically and posted by the mailing house, R.L.Polk, on Friday 13 December 1991. Each letter is on appropriate Branch Office letterhead, but signed by the National Program Manager (Benefits). The envelopes contain:

.Categories l & 2. A personalised letter printed on both sides of a single A4 sheet, a Pharmaceutical Pamphlet (black and white side one, blue side two), a Prescription Record Form and an RPBS 1991 Budget Arrangements glossy brochure.

.Categories 3 to 8. A personalised letter printed on both sides of a single A4 sheet and an RPBS 1991 Budget Arrangements glossy brochure.

3. Copies of each letter and the Pharmaceutical Pamphlet are at Annexes 1 to 9.

4. Categories nine and ten will be sent manually by Branch Offices (mostly from Tasmania) in response to a computer listing of veterans with STEC or PTEC living overseas which will be sent to each Branch Office. A copy of each letter is at Annex 10 and 11. The letter, which need not be personalised as it starts "Dear Veteran", should be reproduced by Branches as required. Each Branch will also be provided with a number of V3 A4 flyers headed "Important Notice" for insertion with the letter. This flyer advises that the letter contains important information in number of different languages.

5. Branch Offices should ensure that these two letters are posted to veterans as soon as possible.

CATEGORY 1- NIL DP/SP/WW WITH S/PTEC (1)

Dear Mr Smith

On 23 September 1991, I wrote to you outlining some important changes to the way pharmaceutical items are to be obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

As I explained, in 1992 prescription items obtained under the RPBS using your Personal or Specific Treatment Entitlement Card (yellow or white) will cost you $2.60 each.

However, to ensure that you are not out of pocket, you will receive a pharmaceutical allowance of $5.20 per fortnight, which is $135.20 per annum. This will be paid from payday 26 December 1991 to the following account:

Bank of Something number 123456789

If you (and your partner) also receive a pension or benefit from the Department of Social Security (other than family allowance) please read the black and white side of the enclosed pamphlet. This explains how the safety net works for you in this circumstance.

If you (or your partner) do NOT receive pension or benefit from Social Security please read the blue side of the enclosed pamphlet. This explains how the safety net works for you in this circumstance.

If your partner does receive a pension or benefit (other than family allowance) from Social Security, but you do not, your partner should advise the local Social Security office of the rate of your Pharmaceutical Allowance.

CATEGORY 2 - DP ONLY (2)

Dear Mr Smith

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

In 1992, prescription items obtained under the RPBS using your Personal or Specific Treatment Entitlement Card (yellow or white) will cost you $2.60 each.

However, to ensure that you are not out of pocket, you will receive a pharmaceutical allowance of $5.20 per fortnight. This will be paid with your disability pension from payday 26 December 1991.

If you (and your partner) also receive a pension or benefit from the Department of Social Security (other than family allowance) please read the black and white side of the enclosed pamphlet. This explains how the safety net works for you in this circumstance.

(3)

Pharmaceutical Benefit Scheme (PBS) prescription items which cost $2.60 are called Concessional PBS items, while items which cost up to $15.70 are called General Patient PBS items. If you have a white card (STEC), you may get some of your prescription drugs as RPBS items and others as General Patient PBS items. If your partner has a Concessional PBS entitlement (e.g. as a War Widow), your partner's Concessional PBS and your RPBS items should all be recorded on the one Prescription Record Form. Your General Patient PBS items should be recorded on a separate Prescription Record Form. The blue side of the pamphlet then applies to you both.

If you use a lot of prescription items you can get an advance of your pharmaceutical allowance by applying to your Veterans' Affairs office before 9 January 1992. You can also apply for an advance if, at any time during 1992, you have paid more for prescription items than you have received in pharmaceutical allowance so far that year. The advance will be equal to seven times your fortnightly rate of allowance.

Also enclosed is a brochure which explains the 1991 Budget arrangements for the RPBS. If you have any questions please contact your Veterans' Affairs Advisory Service at the address or telephone number shown at the top of this letter.

Most veterans will be better off- none will be worse off. The allowance covers 52 prescription items a year. If you're like most veterans, you'll use fewer prescription items than this. The difference is money in your pocket.

The extension of charging for pharmaceutical items to the RPBS is part of the overall strategy to encourage a more thoughtful and responsible use of drugs within the community and reduce unnecessary wastage. If you use prescription drugs regularly, please take the opportunity to discuss them with your doctor at your next appointment.

Yours faithfully,

PETER HAWKER

NATIONAL PROGRAM DIRECTOR

BENEFITS PROGRAM

(Black & White)(4)

Please read this side if you (AND your partner receive a pension or benefit from the Department of Social Security

In 1992, the Department of Social Security will no longer pay you (or your partner) the Pharmaceutical Allowance. This is because Veterans' Affairs will pay $5.20 to all Personal and Specific Treatment Entitlement Card holders (white and yellow).

To assist those who use a lot of prescription items, the safety net has been extended to include both the Repatriation Pharmaceutical Benefits Scheme (RPBS) and the Pharmaceutical Benefits Scheme (PBS). You (and your family) will not have to pay for more than a combined total of 52 prescription items in a calendar year. This includes repeat supplies. To ensure that you do not pay for more, you should continue to keep a Prescription Record Form. Your Chemist should record on this form details of your RPBS and PBS concessional purchases. Enclosed is a Prescription Record Form to use in 1992 for your RPBS and PBS items.

When you (and your family) have recorded a total of 52 prescription items, which is $135.20, you should ask your Chemist to issue you a Safety Net Entitlement Card. This card will enable you (and your family) to obtain all pharmaceuticals under both the RPBS and the PBS free for the rest of the calendar year. You will still be required to pay any gap fee for dearer priced brands.

(blue) (5)

Please read this side if you (OR your partner) DO NOT receive a pension or benefit from the Department of Social Security

To assist those who use a lot of prescription items, a safety net has been introduced for the Repatriation Pharmaceutical Benefits Scheme (RPBS) items which will operate together with your Pharmaceutical Benefits Scheme (PBS) safety net.

Enclosed is a Prescription Record Form to use in 1992 for your RPBS items. You should ensure your Chemist records each RPBS prescription item on this form. If you (or your family) also obtain prescription items under the General PBS (that is those prescriptions items which you are charged up to $15.70) in 1992, you should obtain a further-Prescription Record Form from your Chemist. You will need to keep two separate Prescription Record Forms.

If the combined total on your two Prescription Record Forms will exceed $309.90 when you add the charge for a prescription item you are getting, you should tell your Chemist. You will then be charged $2.60 for that item. You will also be issued with a Safety Net Concession Card. When you present this card you (and your family) will be charged only $2.60 for RPBS and PBS prescription items. You should also start a new Prescription Record Form. The number of prescription items which made up this $309.90 should also be recorded on the new form. Ask your Chemist to sign the entry.

When you have 19 items recorded on this new form, the next pharmaceutical item you obtain will be issued free of charge. You will also be issued with a Safety Net Entitlement Card, which will enable you (and your family) to obtain all subsequent prescription items free for the rest of the calendar year. You will still be required to pay any gap fee for dearer priced brands.

If your Prescription Record Forms show a combined total of 52 prescription items, including repeat supplies, before you have reached the safety net by the method described above, you should ask your Chemist to issue you with a Safety Net Entitlement Card.

CATEGORY 3 - SP SINGLE WITH S/PTEC (6)

Dear Mr Smith

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

In 1992, the first 52 prescription items you use, including repeat supplies, will cost you $2.60 each. This includes prescription items obtained under the Pharmaceutical Benefits Scheme (PBS) using your Pensioner Health Benefits or Pharmaceutical Benefits Concession card. It now also includes items obtained under the RPBS using your Personal or Specific Treatment Entitlement Card (yellow or white).

You will continue to receive a pharmaceutical allowance of $5.20 per fortnight, which is a total of $135.20 per annum.

To assist those who use a lot of prescription items, the safety net has been extended to include both the RPBS and the PBS. You will not have to pay for more than 52 prescription items in a calendar year, which is $135.20. This includes repeat supplies.

CATEGORY 4 - SP MARRIED NOT SEPMED with S/PTEC (7)

Dear Mr & Mrs Smith

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

In 1992, the first 52 prescription items used by your family, including repeat supplies, will cost you $2.60 each. This includes prescription items obtained under the Pharmaceutical Benefits Scheme (PBS) using your Pensioner Health Benefits or Pharmaceutical Benefits Concession card. It now also includes items obtained under the RPBS using your Personal or Specific Treatment Entitlement Card (yellow or white).

You will both continue to receive a pharmaceutical allowance of $2.60 each per fortnight, which is a combined total of $135.20 per annum.

To assist those who use a lot of prescription items, the safety net has been extended to include both the RPBS and the PBS. You (and any dependant children) will not have to pay for more than 52 prescription items in a calendar year, which is $135.20. This includes repeat supplies.

CATEGORY 5 - SP MARRIED (SEPMED) WITH S/PTEC (8)

Dear Mr & Mrs Smith

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

You will both continue to receive a pharmaceutical allowance of $5.20 each per fortnight while you are separated due to illness.

CATEGORY 6 - WAR WIDOW WITH PTEC (9)

Dear Mrs Smith

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

In 1992, the first 52 RPBS prescription items you get using your Personal Treatment Entitlement Card (yellow) will cost you $2.60 each.

You will continue to receive a pharmaceutical allowance of $5.20 per fortnight which is a total of $135.20 per annum.

For those who use a lot of prescription items, the safety net has been extended to include the RPBS. You will not have to pay for more than a total of 52 prescription items in a calendar year, which is $135.20. This includes repeat supplies.

If you have remarried, or have dependant children, you will have a special combined safety net. Your Branch Office can explain how this will work for you.

To ensure that you do not pay for more than 52 items, you should continue to keep a Prescription Record Form. Your Chemist should record on this form details of your $2.60 prescription items. In 1992 you will need a new form which is available from your chemist.

CATEGORY 7 - SP MARRIED with S/PTEC Married to

WW NOT SP (10)

Dear Mr & Mrs Smith

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

In 1992, the first 52 prescription items used by your family, including repeat supplies, will cost you $2.60 each. This includes prescription items obtained under the Pharmaceutical Benefits Scheme (PBS) at the concessional charge of $2.60. It now also includes items obtained under the RPBS using your Personal or Specific Treatment Entitlement Card (yellow or white).

You will both continue to receive a pharmaceutical allowance.

To assist those who use a lot of prescription items, the safety net has been extended to include both the RPBS and the PBS. You and your family will not have to pay for more than 52 prescription items in a calendar year which is $135.20. This includes repeat supplies.

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When your Prescription Record Form(s) shows a total of 52 prescription items, including repeat supplies, you should ask your Chemist to issue you with a Safety Net Entitlement Card. This card will enable you to obtain all pharmaceuticals under both the RPBS and the PBS free for the rest of the calendar year. You will still be required to pay any gap fee for dearer priced brands.

If you use a lot of prescription items you can get an advance of your pharmaceutical allowance by applying to your Veterans' Affairs office before 9 January 1992. You can also apply for an advance if, at any time during 1992, you have paid more for prescription itemsthan you have received in pharmaceutical allowance so far that year. The advance will be equal to seven times your fortnightly rate of allowance.

Enclosed is a brochure which explains the 1991 Budget arrangements for the RPBS. If you have any questions please contact your Veterans' Affairs Advisory Service at the address or telephone number shown at the top of this letter.

Yours faithfully,

PETER HAWKER

NATIONAL PROGRAM DIRECTOR

BENEFITS PROGRAM

CATEGORY 8 - SP 04 with S/PTEC NOT Married to

WW nor to DP ONLY(12)

Dear Mr Smith

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

In 1992, the first 52 prescription items you use, including repeat supplies, will cost you $2.60 each. This includes prescription items obtained under the Pharmaceutical Benefits Scheme (PBS) at the concessional charge of $2.60. It now also includes items obtained under the RPBS using your Personal or Specific Treatment Entitlement Card (yellow or white).

You will continue to receive a pharmaceutical allowance of $5.20 per fortnight, which is a total of $135.20 per annum.

To ensure that you do not pay for more than 52 items, you should continue to keep a Prescription Record Form. Your Chemist should record on this form details of your RPBS and PBS $2.60 prescription items. In 1992 you will need a new form which is available from your chemist. Other PBS prescription items which cost up to $15.70 are called General Patient PBS items. A separate Prescription Record Form should be kept for all General Patient PBS items.

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Yours faithfully,

PETER HAWKER

NATIONAL PROGRAM DIRECTOR

BENEFITS PROGRAM

CATEGORY 9 - SP WITH S/PTEC AND OVERSEAS (14)

Dear Veteran

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

In 1992, prescription items obtained under the RPBS using your Personal or Specific Treatment‑Entitlement Card (yellow or white) will cost $2.60 each.

While you continue to live overseas, reimbursement in respect of pharmaceutical items for accepted disabilities will be reduced by $2.60 per item.

You (and your partner) will continue to receive a pharmaceutical allowance of $5.20 per fortnight (combined).

If you return to Australia, you should check with your Veterans' Affairs Advisory Service who will explain how the safety net operates for those who use a lot of prescription items in Australia.

Yours faithfully,

CATEGORY 10 - DP ONLY AND OVERSEAS (15)

Dear Veteran

In the August Budget the Government announced some important changes to the way pharmaceutical items are obtained under the Repatriation Pharmaceutical Benefits Scheme (RPBS).

In 1992, prescription items obtained under the RPBS using your Personal or Specific Treatment Entitlement Card (yellow or white) will cost $2.60 each.

While you continue to live overseas, reimbursement in respect of pharmaceutical items for accepted disabilities will be reduced by $2.60 per item.

However, to ensure that you are not out of pocket, you will receive a pharmaceutical allowance of $5.20 per fortnight. This will be paid with your disability pension from payday 26 December 1991.

If you return to Australia, you should check with your Veterans' Affairs Advisory Service who will explain how the safety net operates for those who use a lot of prescription items in Australia.

The extension of charging for pharmaceutical items to the RPBS is part of the overall strategy to encourage a more thoughtful and responsible use of drugs -within the community and reduce unnecessary wastage. If you use prescription drugs regularly, please take the opportunity to discuss them with your doctor at your next appointment.

Yours faithfully,

Source URL: https://clik.dva.gov.au/compensation-and-support-reference-library/departmental-instructions/1992/b021992-pharmaceutical-allowance-processing-guidelines-advance-payments-advice-letters-deaths-bereavement-payments-and-recovery