Access to HIV treatment for people without Medicare
Australia is transitioning from an industry-sponsored antiretroviral treatment (ART) compassionate access scheme to a Federation Funding Agreement (FFA) model that provides free or affordable access to ART for people with HIV who do not have Medicare.
The states and territories are transitioning to a new scheme whereby people with HIV without Medicare are able to access their HIV treatment free of charge or at low cost through government-funded hospital pharmacies or other locations to be determined by State and Territory Departments of Health.
Note: Only the cost of the medication is covered under this scheme. Additional costs associated with care or side effects from treatment will not be covered.
Each State and Territory Department of Health are in the process of finalising their transition to new government-funded schemes. This webpage will be updated as details are confirmed in each state and territory. During the transition time, HIV treatment continues to be provided by pharmaceutical companies. As such, it is advised that provision of care, and access to treatment, continue until further notice.
For more information:
ASHM will continue to update the sector as new information comes to light. Please direct any questions or concerns to ASHM at HIVPrescriber@ashm.org.au.
Community members can find information on the NAPWHA website.
Click the dropdown boxes below for details on the new scheme in your state or territory:
The NSW Government has published a new NSW Health Guideline HIV treatment for people in NSW who are not eligible for Medicare [GL2023_015] which outlines the eligibility criteria, prescribing, dispensing and reimbursement requirements for s100 prescribers and public hospital pharmacists.
Under the new scheme in NSW, people with HIV without Medicare can continue to receive their treatment for free through public hospital pharmacies.
Patients are strongly encouraged to return to the same hospital pharmacy to collect their treatment.
If collecting HIV treatment from a public hospital pharmacy is difficult for your patient because of distance or other factors, you can contact the hospital pharmacy to discuss other access options. You can search for local public hospitals here.
There is no need for people with HIV without Medicare to change their doctor to access the scheme, unless their current doctor is not authorised to prescribe HIV treatment, in which case they should be referred to one who is. In primary care, HIV treatment can only be prescribed by an accredited s100 prescriber.
If you have any questions about what this means for you or your patients, please do not hesitate to contact us at HIVPrescriber@ashm.org.au.
Clients can contact Positive Life NSW for information, referral and advice on accessing HIV care and treatment in NSW.
UPCOMING WEBINAR: ASHM is hosting a webinar about the changes and guidelines for healthcare workers in NSW on 25th May at 12pm. To attend the webinar or receive the recording, please click below.
Register nowThe Northern Territory has now transitioned to the Federation Funding Agreement model as of 3 March 2023.
Under the new scheme in the Northern Territory, people with HIV without Medicare can continue to receive their medication for free through hospital pharmacies or Clinic 34.
There is no need for people with HIV without Medicare to change their doctor to access the scheme, unless their current doctor is not authorised to prescribe HIV treatment, in which case they should be referred to one who is. In primary care, HIV treatment can only be prescribed by an accredited s100 prescriber.
Under this scheme, HIV treatment will need to be dispensed from Clinic 34 or a hospital pharmacy. If this is difficult for your patient because of distance or other factors, you can discuss other access options with Clinic 34. You can find contact information for your local Clinic 34 here.
If you have any questions about what this means for you or your patients, please do not hesitate to contact us at HIVPrescriber@ashm.org.au.
For information to share with people with HIV without Medicare, visit the National Association of People with HIV Australia (NAPWHA) webpage about the change.
The new scheme is now in effect in South Australia as of 30 March 2023.
There are no changes to the previous arrangements for access to HIV clinical care under this new scheme in SA. There is no need for people with HIV without Medicare to change their doctor to access the scheme, unless their current doctor is not authorised to prescribe HIV treatment, in which case they should be referred to one who is.
Access to HIV treatments funded under this program will be coordinated by the Royal Adelaide Hospital (RAH) Infectious Diseases Unit (IDU). If you have a client living with HIV who is Medicare ineligible, please contact RAH IDU on (08) 7074 0000 to arrange access to treatment under this program.
Under this program HIV treatment will need to be dispensed from a SA Health pharmacy. If this is inconvenient for your client, please discuss this with RAH IDU to make alternative arrangements for access to treatment.
Clients do not have to make a co-payment for HIV ART, if accessed through this program.
Please note that this program does not include HIV pre- or post-exposure prophylaxis (PrEP or PEP).
For more information please see:
For information to share with people without Medicare, visit the NAPWHA website.
If you have any questions please do not hesitate to contact us at HIVPrescriber@ashm.org.au.
Tasmania implemented the Federation Funding Agreement model on 8 May 2023.
Under this new scheme in Tasmania, people with HIV without Medicare can receive their treatment at similar costs to Medicare eligible people through government-funded hospital pharmacies.
HIV treatment is prescribed by Sexual Health Service Tasmania clinics (Clinic 23, 34 or 60) and accredited s100 prescribers in primary care.
If collection from a hospital pharmacy is difficult because of distance or other factors, you can discuss other access options with Sexual Health Services. Information on your local Sexual Health Service Clinic is available here: Sexual Health Services | Tasmanian Department of Health
For information to share with people without Medicare, visit the National Association of People with HIV Australia (NAPWHA) webpage.
If you have any questions about what this means for you or your clients, please do not hesitate to contact us at HIVPrescriber@ashm.org.au.
Under this scheme in Western Australia, people without Medicare can continue to receive their HIV treatment for free through hospital outpatient pharmacies.
Under this scheme, HIV treatment must be dispensed from a hospital pharmacy. If this is difficult for your client because of distance or other factors, arrangements for delivery to a suitable location can continue (courier fees may apply).
There is no need for people with HIV without Medicare to change their doctor to access the scheme, unless their current doctor is not authorised to prescribe HIV treatment at a public hospital, such as GP s100 prescribers. In these cases, people without Medicare should be referred to one of WA’s immunology or infectious disease clinics at a metropolitan public hospital, who will organise their access to HIV treatment.
Guidelines on the implementation of the scheme in WA are in development and will be shared when available.
For information to share with people without Medicare, visit the National Association of People with HIV Australia (NAPWHA) webpage.
If you have any questions about what this means for you or your patients, please do not hesitate to contact us at HIVPrescriber@ashm.org.au.
UPCOMING WEBINAR: ASHM is hosting a webinar to provide healthcare workers with guidance on the scheme in WA on 28th June at 12pm AWST. Information will be presented by WA Health, an HIV s100 prescriber and a lived experience speaker. To attend the webinar or receive the recoding, please click the link below.
Register now