7.1 Plans Overview

[August 21, 2019: Updated to reflect the addition of Plan Z]

In This Section

Section 7 provides information on the 12 PharmaCare plans:

1. Fair PharmaCare (Plan I)
2. Permanent Residents of Licensed Residential Care Facilities (Plan B)
3. Recipients of Income Assistance (Plan C)
4. Cystic Fibrosis (Plan D)
5. Children in the At Home Program (Plan F)
6. Psychiatric Medications (Plan G)
7. Palliative Care (Plan P)
8. First Nations Health Benefits (Plan W)
9. Medication Management (Plan M)
10. Smoking Cessation Program (Plan S)
11. British Columbia Centre for Excellence in HIV/AIDs (Plan X)
12. Assurance (Plan Z)

General Policies

Acute care and extended care patients

PharmaCare coverage is not extended to patients in acute or extended care hospitals unless otherwise noted under the specific plan.

Overpayment of assistance

PharmaCare may seek recovery of any overpayment of assistance if the beneficiary is later determined to have been ineligible for that assistance. This policy applies to all PharmaCare plans and to all items that PharmaCare covers.

Relationship to other drug plans

Federal insurers

PharmaCare is the insurer of last resort for individuals covered by federal drug plans including the Canadian Forces, Veterans’ Affairs or Non-Insured Health Benefits.

For individuals covered under federal plans, PharmaCare covers only items eligible for PharmaCare coverage that are not eligible for coverage under the individual’s federal drug plan.

Supplemental insurers

PharmaCare does cover individuals who have supplemental health plans (usually private insurers). These insurers may pay costs not covered by PharmaCare (such as amounts under the Fair PharmaCare deductible).

PharmaCare does not coordinate or direct supplemental health plans as to who or what the private insurers cover.

>> For more information please see Section 3.4—Claims, Patients - Other Insurers. 

BC PharmaCare and patient support programs

As a public support program, PharmaCare coverage is not tied to participation in a patient support program run by a drug manufacturer. Beneficiaries are not required to enrol in a private patient support program to be eligible for PharmaCare coverage.

For one in 10 prescription drugs sold in Canada, the drug manufacturer offers a patient support program. The programs offer some supports, such as patient education, for using a particular brand of drug. To enrol in a patient support program, patients are usually required to provide persona information, including medical information, which the company will share with others. PharmaCare coverage is not affected if a beneficiary voluntarily chooses to participate in a patient support program.