Commonwealth Numbered Acts

SOCIAL SECURITY LEGISLATION AMENDMENT ACT (No. 4) 1991 No. 194, 1991 - SECT 48

48. Parts 2.22 and 2.23 of the Principal Act are repealed and the following
Parts are substituted:

"PART 2.22 - PHARMACEUTICAL ALLOWANCE

"Division 1 - Qualification for and payability of pharmaceutical allowance
Qualification for pharmaceutical allowance

"1061A.(1) A person is qualified for a pharmaceutical allowance if:

   (a)  the person is receiving a social security pension; or

   (b)  the person is receiving job search allowance and:

   (i)  the person has not turned 18; and

   (ii) the person is incapacitated for work; and

   (iii) subsection 514(2) applies to the person; or

   (c)  the person is receiving job search allowance and:

   (i)  the person has turned 18; and

   (ii) the person is incapacitated for work; and

   (iii) subsection 514(3) applies to the person; or

   (d)  the person is receiving newstart allowance and:

   (i)  the person is incapacitated for work; and

   (ii) either subsection 594(2) or (3) applies to the person; or

   (e)  the person is receiving sickness allowance.

"(2) A person is qualified for a pharmaceutical allowance if the person:

   (a)  is receiving job search allowance, newstart allowance or special
        benefit; and

   (b)  has turned 60; and

   (c)  has been receiving:

   (i)  a social security pension or benefit; or

   (ii) a service pension; continuously for at least 6 months. Pharmaceutical
        allowance not payable in some circumstances

"1061B.(1) Even though a person is qualified for a pharmaceutical allowance,
the allowance is not payable to the person if on that payday:

   (a)  the person is not an Australian resident; or

   (b)  the person is absent from Australia; or

   (c)  the person has received an advance pharmaceutical allowance:

   (i)  under Part 2.23 of this Act; or

   (ii) under Division 2 of Part VIIA of the Veterans' Entitlements Act; and
        the person's advance payment period has not ended.

"(2) Even though a person has qualified for a pharmaceutical allowance, the
allowance is not payable to the person if:

   (a)  the person is receiving pharmaceutical allowance under the Veterans'
        Entitlements Act; or

   (b)  the person is a member of a couple and the person's partner:

   (i)  is eligible for pharmaceutical allowance under the Veterans'
        Entitlements Act; and

   (ii) is not receiving a service pension.

"(3) For the purposes of subsection (1), a person's advance payment period:

   (a)  starts on the day on which the advance pharmaceutical allowance is
        paid to the person; and

   (b)  ends after the number of paydays worked out using the following
        formula have elapsed:
amount of advance
allowance rate where: `amount of advance' is the amount of the advance
pharmaceutical allowance paid to the person; `allowance rate' is the rate at
which pharmaceutical allowance would be payable to the person on the day on
which the advance pharmaceutical allowance is paid if the person were paid
pharmaceutical allowance on that day.

"(4) In subsection (3): `advance pharmaceutical allowance' includes advance
pharmaceutical allowance under Division 2 of Part VIIA of the Veterans'
Entitlements Act; `pharmaceutical allowance' includes pharmaceutical allowance
under Division 1 of Part VIIA of the Veterans' Entitlements Act. Note: for
`Veterans' Entitlements Act' and `service pension' see subsection 23(1).

"Division 2 - Rate of pharmaceutical allowance Rate of pharmaceutical
allowance

"1061C.(1) The rate of pharmaceutical allowance is worked out using the
following Table:
PHARMACEUTICAL ALLOWANCE RATE TABLE
    column 1   column 2                      column 3

    item       person's family situation     rate per fortnight

    1.         Not member of a couple           $5.20

    2.         Partnered (partner getting

neither social security pension
               nor benefit)                     $5.20

    3.         Partnered (partner getting

social security pension or
               benefit)                         $2.60

    4.         Member of an illness

separated or respite care couple $5.20
    5.         Partnered (partner getting

               service pension)                 $2.60
Note: the amounts in column 3 are indexed or adjusted annually in line with
CPI increases (see sections 1191 to 1194 and section 1206A).

"(2) If item 5 applies to a person, item 2 does not apply to the person.
Limitation of amount of pharmaceutical allowance

"1061D.(1) If a person receives advance pharmaceutical allowance during a
calendar year, the total amount paid to the person for that year by way of:

   (a)  pharmaceutical allowance; and

   (b)  advance pharmaceutical allowance; is not to exceed the person's
        pharmaceutical payments limit for that year.

"(2) A person's pharmaceutical payments limit for the year is the total amount
of pharmaceutical allowance that the person would have received during the
year if the person had not received any advance pharmaceutical allowance.

"(3) In this section: `advance pharmaceutical allowance' includes advance
pharmaceutical allowance under Division 2 of Part VIIA of the Veterans'
Entitlements Act; `pharmaceutical allowance' includes pharmaceutical allowance
under Division 1 of Part VIIA of the Veterans' Entitlements Act. Note: for
`Veterans' Entitlements Act' see subsection 23(1).

"Division 3 - Payment of pharmaceutical allowance Payment of pharmaceutical
allowance

"1061E. If:

   (a)  a pharmaceutical allowance is payable to a person; and

   (b)  the person is receiving a social security pension or benefit; the
        pharmaceutical allowance is to be paid to the person on each payday
        for the pension or benefit.

"PART 2.23 - ADVANCE PHARMACEUTICAL ALLOWANCE

"Division 1 - Qualification for and payability of advance
pharmaceutical allowance Qualification for advance pharmaceutical allowance

"1061F.(1) A person is qualified for an advance pharmaceutical allowance if:

   (a)  the person is receiving a social security pension; and

   (b)  the Secretary is satisfied that the person's ordinary income is not
        more than $20.00 per fortnight.

"(2) For the purposes of this section, a person's ordinary income does not
include:

   (a)  a payment:

   (i)  that the person is entitled to under the law of a foreign country; and

   (ii) that results in the person's social security pension rate being
        reduced by an amount equal to the amount of the payment; or

   (b)  a periodic compensation payment to which Part 3.14 applies.

"(3) For the purposes of this section, if a person is a member of a couple the
amount of the person's ordinary income is worked out by adding the couple's
ordinary incomes (on a fortnightly basis) and dividing by 2. Advance
pharmaceutical allowance not payable in some circumstances

"1061G.(1) Even though a person is qualified for an advance pharmaceutical
allowance, the allowance is not payable to the person on a payday if on that
payday:

   (a)  the person is not an Australian resident; or

   (b)  the person is absent from Australia.

"(2) Even though a person is qualified for an advance pharmaceutical
allowance, the allowance is not payable to the person if:

   (a)  the person is a member of a couple; and

   (b)  the person's partner:

   (i)  is eligible for an advance pharmaceutical allowance under the
        Veterans' Entitlements Act; and

   (ii) is not receiving a service pension. Note: for `Veterans' Entitlements
        Act' and `service pension' see subsection 23 (1).

"(3) If, in a calendar year:

   (a)  a person is qualified for an advance pharmaceutical allowance; and

   (b)  the amount of the allowance is reduced under section 1061JD; no
        further advance pharmaceutical allowance is payable to the person in
        that calendar year.

"Division 2 - Claim for advance pharmaceutical allowance Need for a claim

"1061H.(1) A person who wants to be granted an advance pharmaceutical
allowance must make a proper claim for that allowance.

"(2) Subject to subsection 1061JB(3), if:

   (a)  a claim for an advance pharmaceutical allowance is made by or on
        behalf of a person; and

   (b)  at the time when the claim is made, the claim cannot be granted
        because the person is not qualified for the payment; the claim is
        taken not to have been made. Form of claim

"1061J. To be a proper claim, a claim must be in writing and in a form
approved by the Secretary. Lodgment of claim

"1061JA.(1) To be a proper claim, a claim must be lodged:

   (a)  at an office of the Department; or

   (b)  at a place approved for the purposes by the Secretary; or

   (c)  with a person approved for the purposes by the Secretary.

"(2) A place or person approved under subsection (1) must be a place or a
person in Australia. Proper claim

"1061JB.(1) A claim must be a proper claim under subsection (2), (3) or (4) to
be a proper claim for the purposes of this Division.

"(2) A claim by a person for advance pharmaceutical allowance to be paid in a
calendar year (in this subsection called the `current year') is a proper claim
if:

   (a)  a social security pension was payable to the person on the last
        pension payday in the previous calendar year; and

   (b)  the claim is lodged before the first pension payday in the current
        year.

"(3) A claim by a person for advance pharmaceutical allowance to be paid in a
calendar year is a proper claim if:

   (a)  the person claims a social security pension in that year; and

   (b)  the claim is lodged:

   (i)  at the time when the claim for the pension is lodged; or

   (ii) before the claim for the pension is granted.

"(4) A claim by a person for advance pharmaceutical allowance to be paid in a
calendar year is a proper claim if:

   (a)  the person has been qualified for pharmaceutical allowance for a
        period (in this subsection called the `qualification period') during
        the calendar year; and

   (b)  the amount spent by the person during the qualification period on the
        purchase of pharmaceutical benefits is equal to or greater than the
        total amount that has been paid to the person in the calendar year by
        way of:

   (i)  pharmaceutical allowance; and

   (ii) advance pharmaceutical allowance.

"Division 3 - Amount of advance pharmaceutical allowance Amount of advance
pharmaceutical allowance

"1061JC. Subject to section 1061JD, the amount of a person's advance
pharmaceutical allowance is the amount worked out by multiplying the person's
rate of pharmaceutical allowance under section 1061C by 7. Reduction in amount
of advance pharmaceutical allowance

"1061JD. If:

   (a)  a person is qualified for an advance pharmaceutical allowance; and

   (b)  the amount worked out under section 1061JC (when added to the amounts
        of pharmaceutical allowance and advance pharmaceutical allowance that
        the person has already received for the calendar year under this Act
        and the Veterans' Entitlements Act) exceeds the person's
        pharmaceutical payments limit under section 1061D; the amount of the
        advance pharmaceutical allowance is to be reduced by the excess.".