7.9 Medication Management (Plan M)

Last updated on April 17, 2024

General Policy Description

Plan M covers individuals for eligible medication management services (e.g., clinical services, medication review services, and publicly funded vaccinations) provided by pharmacies.

Policy Details

 

Eligibility

Coverage is provided for individuals, rather than families.

Coverage under Plan M does not extend to patients in acute or extended care hospitals.

Patients covered under Plan B (Permanent Residents of Licensed Long-term Care Facilities) are not covered for Medication Review Services.

Eligibility for coverage under Plan M is established in Section 8.4—Clinical Services FeesSection 8.9—Medication Review Services and Section 8.10—Pharmacist Administration of Drugs and Vaccines.

 

Coverage start date

Individuals are eligible for Plan M coverage if they meet the eligibility requirements for coverage established in Section 8.4—Clinical Services FeesSection 8.9—Medication Review Services or Section 8.10—Pharmacist Administration of Drugs and Vaccines.

Plan M coverage cannot be provided retroactively.

 

What is covered?

Plan M covers the cost of clinical services, medication review services and publicly funded vaccination services provided by pharmacies up to the limits PharmaCare has established for these services.

>> For information on eligible benefits and limits, see Section 8.4—Clinical Services Fees, Section 8.9—Medication Review Services, and Section 8.10—Pharmacist Administration of Drugs and Vaccines.

 

Procedures

For procedural information for pharmacists, refer to Section 8.4—Clinical Services Fees, Section 8.9—Medication Review Services, and Section 8.10—Pharmacist Administration of Drugs and Vaccines.