Interactive eligibility checker · PBS Schedule 2026
PBS Authority Decision Tree: Are You Eligible for $31.60/month Ozempic? (2026)
PBS Authority Streamlined for Ozempic (semaglutide) gives eligible type 2 diabetes patients $31.60/month general script ($7.70 concession) — vs $250+/month at private price. Most patients don\'t know they qualify. Answer 5 questions below to check eligibility, then take the talking points to your GP.
★Key takeaways
- ✓PBS Authority Streamlined for Ozempic: $31.60/month general script ($7.70 concession) — saves $1,800–$2,800/year vs private.
- ✓Eligibility: confirmed T2D + HbA1c above PBS threshold + metformin trial + GP-issued Authority code on script.
- ✓Wegovy + Mounjaro NOT on PBS for weight loss as at January 2026 — patients pay full private price ($330–$450/month).
- ✓Your GP can prescribe; no phone authority required. Just bring your latest HbA1c result + medication history.
- ✓If you don't meet PBS criteria: telehealth ($290–$450/month) or in-person clinic ($280–$400/month + program fee) are your options.
5-question PBS Authority eligibility checker
Not medical advice. Final eligibility is your GP\'s call against the current PBS Schedule. This tool reflects the published Streamlined criteria as at January 2026.
Q1. Do you have a diagnosed type 2 diabetes (T2D)?
Q2. Is your HbA1c (3-month average blood sugar) above 7.0% (or 53 mmol/mol)?
Q3. Are you currently taking metformin (or have you tried it)?
Q4. Have you tried at least one other diabetes medication (sulfonylurea, DPP-4 inhibitor like sitagliptin, SGLT-2 inhibitor like empagliflozin) in addition to metformin?
Q5. Do you have a regular GP who manages your diabetes?
What to take to your GP
If the checker says you\'re likely eligible, here\'s what to bring to your GP appointment:
- Your latest HbA1c result. Within the last 3 months ideally. Bring the printed pathology report or have it accessible on My Health Record.
- List of current + previous diabetes medications. Including doses + duration + reason for stopping (if applicable).
- Your full medication list (including supplements + over-the-counter). GP needs to check for contraindications.
- The specific Authority Streamlined code request. Print the PBS listing for semaglutide and bring it. Code numbers change periodically; current list at pbs.gov.au.
- Your willingness to commit to lifestyle changes. GLP-1 + lifestyle is the gold-standard pathway. GPs are more comfortable prescribing to engaged patients.
If you don\'t qualify (no T2D)
Off-label Ozempic for weight loss is private-priced ($150-$250/month script + GP consultation fees). Since 2023 supply shortages, many GPs are reluctant to prescribe off-label Ozempic, preferring Wegovy (TGA-registered for weight loss, similar molecule). Practical options:
- Wegovy via your GP: $250-$380/month script + GP consultations (Medicare-rebated)
- Mounjaro via your GP: $250-$380/month script + GP consultations
- Telehealth subscription: $290-$450/month (Juniper, Mosh, Pilot, Compass) — includes consult + script + admin + delivery
- In-person medical clinic: $280-$400/month script + $250-$500 program fee — comprehensive metabolic work-up included
Common questions
What is PBS Authority Streamlined?
PBS Authority Streamlined is a Pharmaceutical Benefits Scheme prescription category for medications that need specific clinical criteria but don't require phone authority. Your GP enters a streamlined code on the prescription. For Ozempic: the code unlocks $31.60/month general script ($7.70 concession) for eligible type 2 diabetes patients.
Why is Ozempic so much cheaper on PBS Authority?
The PBS is the Federal Government's medication subsidy scheme. Subsidised medications are heavily discounted at point of sale; the government pays the difference to the manufacturer. Off-PBS, the same medication costs $150-$250 (private script) or $290-$450 (telehealth subscription). PBS Authority saves you $1,800-$2,800 per year.
Can I get Wegovy or Mounjaro on PBS?
No — as at January 2026, Wegovy (semaglutide 2.4mg for weight loss) and Mounjaro (tirzepatide) are NOT on the PBS for weight loss in Australia. Only Ozempic (lower-dose semaglutide for type 2 diabetes) qualifies under Authority Streamlined.
What if I have pre-diabetes but not full T2D?
Pre-diabetes (impaired fasting glucose or impaired glucose tolerance) does NOT meet PBS Authority criteria for Ozempic. You'd pay private price. However, prevention of T2D progression is a strong clinical argument — discuss with your GP about other strategies (metformin, lifestyle, GLP-1 prevention trials).
What HbA1c level do I need?
The exact threshold varies by Streamlined code variant. Typically >7% (53 mmol/mol) despite metformin therapy. Some indications use lower thresholds for specific combinations. Your GP checks the current PBS Schedule for exact requirements at prescription time.
What if my GP refuses to prescribe?
Some GPs are conservative about prescribing GLP-1s, particularly for younger patients or where there's any concern. Options: (1) Get a second opinion from another GP, (2) Ask for an endocrinologist referral (specialist may prescribe more readily), (3) Consider a telehealth platform that's GLP-1-experienced (Juniper, Mosh, Pilot), but be aware these typically use Wegovy/Mounjaro at private price, not Ozempic on PBS.
How long is the PBS Authority valid?
Each prescription is for a specific quantity (typically 1-month supply with 5 repeats). The Authority Streamlined code is entered each time. The underlying eligibility (T2D + HbA1c documentation) doesn't need re-checking constantly — your GP keeps eligibility evidence on file.
Next step
Compare full cost across all GLP-1s with our Ozempic vs Wegovy vs Mounjaro vs Saxenda guide. Use the BMI + pathway calculator to see the recommended treatment for your situation.