Yes, our Pharmaceutical Benefits cover Mounjaro, but a recent change by the manufacturer of Mounjaro, Eli Lily, has affected how much members can claim in benefits.
Police Health pays benefits per dispensed pharmacy item, not per dose, and this condition applies to all medications.
On 27 June 2025, Eli Lily informed the Therapeutic Goods Administration that it has stopped producing one-dose Mounjaro vials due to commercial reasons. However, its four-dose Kwik Pen remains available.
Police Health members can still claim $60 in benefits per pharmacy item, but this change from the manufacturer means that the $60 claim covers four doses (Kwik Pen), not one-dose (Vials).
This reflects the manufacturer’s decision to change the dosage per pharmacy item, not a reduction in our cover. Annual Maximums also remain unchanged.
You can read more information about our pharmacy benefits by clicking here.
*Subject to waiting periods, and other terms and conditions
By law private health insurers aren’t allowed to cover out-patients’ consultations or treatments. Instead this cost will be covered by Medicare, but if you’re not bulk billed, you’ll most likely have to pay something too.
You’re considered an out-patient if you receive treatment at a doctor’s office, clinic, or emergency department (without or before being admitted to hospital). Examples include GP visits, specialist consultations, scans, injections, and minor procedures in clinics.
In these cases Medicare will pay 85% of the Medicare Scheduled Fee for these services, and you pay the remaining 15%.
An exception to this is visits to your GP. Medicare pays 100% of the Medicare Scheduled Fee for GP appointments, and you will only have to pay something if the GP charges above the Scheduled Fee (which means they don't bulk bill).
If you are thinking about having a baby, then it’s a good time for you to review your private health insurance and make sure you understand what your policy does and doesn’t cover.
Waiting Periods of up to 12 months can apply for pregnancy, birth and newborn related health services, so if you’re unsure whether you are on the right cover for your growing family, please read our pregnancy and private health insurance guide or contact us.
No, Police Health offers private health insurance – Gold Hospital, Rolling Extras and Gold Combined. It's important to remember your Police Health cover is Australia-wide, so you're still covered from a health insurance point of view if you're travelling within Australia.
For example, your Unlimited Ambulance cover* can be used when you're travelling in Australia.
*All benefits may be subject to Waiting Periods, Limits and other conditions. Unlimited Ambulance cover for emergency transport, clinically required non-emergency transport and treatment not requiring transport (Subject to waiting periods and other conditions).