Your Choices...Your Health What You'll Pay Information on what you’ll pay to see a doctor and for prescriptions is provided below. If you have further questions contact your District Health Board (DHB). You can also email the Ministry of Health’s Primary Health Care team at Emailmoh@moh.govt.nz How do I qualify to receive cheaper fees and cheaper prescriptions? Do refugees qualify? Are there limits placed on what GPs can charge the public? What happens if I haven’t been to the doctor for three years? I have just enrolled. Why am I charged a higher fee as if I wasn't enrolled? How much should I pay? How do I qualify to receive cheaper fees and cheaper prescriptions? In most circumstances, everyone who is eligible for publicly funded health and disability services will now qualify for cheaper fees and prescriptions. To check whether you are eligible, check the Eligibility Direction at www.moh.govt.nz/eligibility. For prescriptions: there is no charge for most medicines for children under six in most cases, eligible persons pay only $3 for subsidised medicines even if they get their prescription from a general practice where they are not enrolled if you go to a DHB hospital or DHB community-based service, you will pay only $3 on prescriptions if you have a Community Services Card or High Use Health Card, you will pay only $3 for each medicine some medicines may not be fully subsidised and will have additional charges. The following diagram illustrates what you’ll pay for prescriptions: * Eligible person means a person eligible for publicly funded health and disability services (refer to www.moh.govt.nz/eligibility). ** Eligible provider/prescriber means: a) a prescriber employed by a DHB; b) a provider/prescriber providing services under an access or service agreement with the Ministry of Health, a DHB or a PHO; c) an After Hours provider with an access or service agreement with a PHO or a DHB; d) a midwife. Text description for flowchart: In most cases, an eligible person pays only $3 for subsidised medicines. Prescriptions for subsidised medicines are free under the following circumstances: If you are an eligible person and your prescription is written by an eligible provider/prescriber and you have a Prescription Subsidy card (PSC) and a Community Services Card (CSC) or a High Use Health Card (HUHC) If you are an eligible person under six years old, even though your prescription is not written by an eligible provider. If you are over 6 years old and have a CSC or HUHC and a PSC. If you don't have a CSC or HUHC but have a PSC, then you pay $2. If you are an eligible person between 6 and 17 years old, don't have a PSC, CSC or HUHC and a prescription that is not written by an approved provider, then you pay $10. If you are an eligible person over 17 years old, don’t have a PSC, CSC or HUHC and a prescription not written by an approved provider, then you pay $15. Back to top Do refugees qualify? People with refugee status in New Zealand are eligible for publicly funded health and disability services. They need to show proof of refugee status such as a letter from the New Zealand Immigration Service confirming that they had been recognised as a refugee, a residence permit or a work permit valid for two or more years. People who are in the process of having an application for refugee status determined by the New Zealand Immigration Service or are in the process of having an appeal heard by the Refugee Status Appeals Authority are also eligible. However, they will need to show proof of an application such as an acknowledgement letter from the Auckland Refugee Status Branch of the New Zealand Immigration Service. Back to top Are there limits placed on what GPs can charge the public? General practices are usually private businesses and have the right to set and charge fees. The Government cannot set general practice fees unless the GP agrees. Some general practices have agreed to set their fees at 0 for children under six years old, $10.50 for those aged 6 to 17 years old and $16 for those over 18 years old. Back to top What happens if I haven’t been to the doctor for three years? Your enrolment will expire if you have not visited your GP in the last three years. The practice will lose your funding and you will be charged the full consultation fee. You don’t have to visit the doctor to be re-enrolled. You can ring and ask your general practice to send you an enrolment form, sign it and send it back to them. Back to top I have just enrolled. Why am I charged a higher fee as if I wasn't enrolled? Funding to general practices is calculated every three months and some practices charge higher fees until they formally receive funding for newly enrolled patients. The Ministry of Health’s view is that practices are funded in a way that accommodates any perceived financial risk. For example, practices receive a budget and retain the funding for enrolled patients for up to three months after they leave the practice. The Ministry of Health believes that enrolled patients should have access to the benefits of enrolment from the date of enrolment. This includes being charged the enrolled fee from the date of enrolment. A person is considered an 'enrolled patient' once they have completed and signed the enrolment form. Back to top How much should I pay? General practice fees have always varied between practices and also depend on what services a practice provides to you. When the increased funding was progressively introduced from July 2002, GPs were required to reduce their standard consultation fee to reflect the level of funding being provided. This resulted in fees reducing but the variation in fees remained. Some practices have agreed to set fees and receive higher levels of funding. These practices charge nothing for children under six years old, $10.50 for those aged 6 to 17 years old and $16 for those over 18 years old. Back to top Website feedback We welcome your feedback on this page. Page last updated: 15 December 2009

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