Patient claim for refund Pharmaceutical Benefits Scheme (PBS) form (PB132)

Use this form to claim a refund under the Pharmaceutical Benefits Scheme (PBS).

Download and complete the Patient claim for refund Pharmaceutical Benefits Scheme (PBS) form.

You can use this form to claim a refund if either you:

  • didn’t show your Medicare card or concession card when you purchased the medicine at the pharmacy
  • spend over your yearly PBS Safety Net threshold.

We can only accept paid receipts and Prescription Record Forms (PRFs) that have been signed by the pharmacist. Tax invoices and patient history reports may be accepted if they’ve been signed and endorsed by the pharmacist as ‘paid in full’ and contain enough information. Pharmacy statement of accounts, cash register and EFTPOS dockets can’t be accepted for a PBS refund claim. Claims with unsigned supporting documents will be returned.

You must attach all documents issued by your pharmacist. We’ll keep all documents supporting this claim.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.

Page last updated: 15 March 2023.
QC 37881