The benefit eligibility process uses a relationship, established by PharmaCare, between a product, its associated benefit group and the plan rules.
Benefit group | Description |
A | No longer a benefit group. Plan discontinued in 2003. |
AD | Alzheimer’s ADTI Medications—Special Authority required |
AM | Seniors over 65 Methadone Maintenance |
B | Residential Care Clients—eligible under Plan B |
C | Recipients of B.C. Income Assistance—eligible under Plan C |
CH | Recipients of B.C. Income Assistance under age 19—eligible under Plans CN, F, K0-K9, KA-KZ, 1K-4K, QN and UK |
CF |
Registered Cystic Fibrosis Clients—eligible under Plan D |
DS |
Syringes and Infusion Sets for Patients with Diabetes—eligible under Plans C, F, I0-9, IA-IZ, 1I-4I, J0-J9, JA-JZ, 1J-2J, Q, UI, and W |
F | At Home Clients—eligible under Plan F |
I2 | Insulin (No Fee Allowed)—eligible under Plans B, C, F, I0-9, IA-IZ, 1I-4I, J0-J9, JA-JZ, 1J-2J, Q, & UI |
LC |
Limited Coverage Items—Special Authority Required |
MH |
Psychiatric Medications—eligible under Plan G A limited number of medications in the formulary are available under the Trial Prescription Program. |
N | Nebulizers for Children Under 19—eligible under Plans CN, F, K0-K9, KA-KZ, 1K-4K, QN, UK and W |
NS | Non-Steroidal Anti Inflammatory—eligible under Plan B |
OS |
Prosthetic / Mastectomy / Ostomy Supplies—eligible under Plans B, C, F, I0-9, IA-IZ, 1I-4I, J0-J9, JA-JZ, 1J-2J, Q, UI, and W* Prosthetic & Mastectomy Product Identification Numbers *Coverage should be obtained through Non-Insured Health Benefits (NIHB). |
PC | Clients Registered for BC Palliative Care Benefits Program |
TA |
Trial Prescriptions—eligible for Plans C, F, I0-9, IA-IZ, 1I-4I, J0-J9, JA-JZ, 1J-2J, Q, UI, and W |
U | Fair PharmaCare clients—eligible under Plans I0-9, IA-IZ, 1I-4I, J0-J9, JA-JZ, 1J-2J, Q, & UI |
W | First Nations Health Benefits—eligible under Plan W, WC, WD, WX |