By Janice Harvey, RPh, CDE
Budgeting for medications can be challenging, especially if you don’t have private insurance. However, there are ways to reduce your costs or to distribute the expense more evenly throughout the year. Here are four tips that you may find helpful.
TIP #1: REGISTER FOR FAIR PHARMACARE
Every resident of British Columbia can qualify for provincial PharmaCare coverage. There are several coverage programs under BC PharmaCare, but the most common is Fair PharmaCare. Under this program, you will have a “family deductible” and a “family maximum” that are based on your family net income. For low-income families, these amounts will be less than they would be for a family with a higher income.
It’s important to understand that this program resets every year on January 1, and the “deductible” and “maximum” may change from one year to the next if your income changes.
Here’s how it works: Fair PharmaCare requires that you pay the full cost of your eligible medications until you reach your deductible, at which point PharmaCare will pay 70% of eligible drug costs. Once you have reached your family maximum, then PharmaCare will pay 100% of those costs.
Registration for Fair PharmaCare is not automatic. You can register online or by phone. Be sure to register even if you have additional insurance coverage, as those plans may refuse to pay if you have not signed up for provincial coverage.
Read or download the Fair PharmaCare Plan information sheet. |
TIP #2: CHOOSE MEDICATIONS THAT ARE COVERED
Only certain drugs are eligible for payment. If you are taking a medication that is not covered by Fair PharmaCare, whatever amount you pay will not count towards either the deductible or the maximum amount. One option is to see if your doctor can apply for “special authority,” which would then make that medication eligible for PharmaCare coverage (each individual application for special authority gets reviewed; approval is not guaranteed). Alternatively, your doctor may be able to prescribe a different medication that is eligible for coverage. Both of these options will help you to meet your deductible faster, so you can get PharmaCare coverage earlier in the year.
You can use the online formulary search to see if a medication is covered as a regular benefit or if special authority is required. Or ask one of our pharmacists. We can also advise your doctor about alternative drug choices when costs are a concern.
Read or download the Special Authority Program information sheet (PDF file). |
TIP #3: SIGN UP FOR MONTHLY DEDUCTIBLE PAYMENTS
If you would like to get immediate help with prescription costs, then you might want to consider PharmaCare’s Monthly Deductible Payment Option (MDPO). To be eligible, you need to be registered for Fair PharmaCare and not have private insurance. When you sign up for this, you will pay your annual family deductible in equal monthly instalments. When picking up prescriptions, PharmaCare will pay 70% of eligible prescription costs and you will pay 30% of those costs. This makes budgeting much easier, as costs are spread out more evenly throughout the year.
For more details, visit the MDPO web page or phone PharmaCare at 1-800-663-7100. |
TIP #4: APPLY FOR AN INCOME REVIEW
Your Fair PharmaCare coverage is based on your income information from two years ago. If your family income has dropped by 10% or more in the past two years, you can apply for an income review, which could reduce your deductible and family maximum. Since you would meet your deductible sooner, PharmaCare would also pay its portion of your prescription costs earlier in the year. And if it turns out that you have paid more than your fair share, PharmaCare will issue a refund in spring of the next year.
For more details, including a link to the application form, visit the income review web page or phone PharmaCare at 1-800-663-7100. |
WE’RE HERE TO HELP
Whether billing prescriptions through PharmaCare or private insurance plans, there are many things to consider. If you have questions about your prescription costs, please let us know and we’ll do our best to find the answers you need.