Copayment Change

From 1^st July 2023, copayments will be automatically removed for certain subsidy codes in RxOne.

Frequently Asked Questions

Q1: What if someone has a community services card (CSC)? Does A1/J1 also become $0?

A: A1/J1 is currently not affected by these changes and remains $5. The current advice is to dispense all scripts as A4/J4, and only use A1/J1 should someone have a specialist script and a CSC. This would be the only scenario where a patient would benefit from the A1 subsidy code. The same applies to A3Z and J3Z.

Q2: What if a patient had a prescription dispensed prior to 1^st July but collects it after 1^st July?

A: Follow your usual procedure of deferring any scripts left on the shelf prior to making the claim (see https://support-hs.atlassian.net/wiki/spaces/RXNZ/pages/50921473/Deferring+Scripts+from+Claim to see how this is done)

Remove the $5 copayment so the patient is not charged (see Q3 below). This is because this script will be claimed after July in which the $5 copayment will no longer be collected by Sector Services. Please note this is only for scripts with a $5 copayment as a result of being dispensed with the A4 or J4 code.

Prescriptions processed before 1 July, deferred in the batch and then claimed after 1 July should show an overpayment of around $4.35 in the line-by-line answerback.

Q3: How do I remove the $5 Copay for scripts dispensed prior to 1^st July?

A: When you sell at POS, give the script 100% Discount to make the total charge $0.00

Open

To allow discounts at POS, you must give an RxOne Staff Member permission to do so through the “Modify Staff” utility. Alternatively, staff will need to get another staff member with discounting permissions

Open

Below is a full list of Subsidy Codes and their charges after 1^st July

Youth (ages 0 to 13 years) – Y Code HUHC

Junior (ages 14 to 17 years) – J Code

Adult (ages 18 and above) – A code

Hokianga Ward of the Far North District – H Code