Provincial Pharmacare Plan May Help You
By Louis Erlichman
Canadian Research Director
In recent years, there have been many advances in drug therapies which can prolong and improve the quality of lives. Unfortunately, the new drugs are often very expensive and can place a heavy burden on individuals and families who require drugs for long-term or chronic conditions.

Workplace drug plans, particularly in unionized workplaces, offer important protection, but we are still a long way from a full-blown national pharmacare program, which is an essential part of a truly comprehensive medicare program. Provincial governments generally provide drug coverage for seniors (in some cases with co-pays and deductibles) and people on welfare, but there are still major gaps in coverage.

Four provinces (B.C., Saskatchewan, Manitoba and Ontario – the provinces with current or previous NDP governments) do have limited pharmacare programs that can help people with high prescription drug costs and no private drug coverage. While these programs vary in their details, they generally pay for drugs over a certain annual deductible based on family income.

For example, in Ontario, a family of four with an annual income of $25,000 will get annual drug costs over $514 paid by the plan. B.C. pharmacare pays 70% of drug bills over $800 a year. The rules can be complicated, so you need to check out if your individual situation entitles you to coverage. In each case, you have to apply and submit receipts.

If government coverage does apply, it could help people facing lay-off in the current recession, and may also encourage early retirements. If your drug plans do not provide for retirees, covering drug costs until government benefits kick in at age 65 is often a key element in the decision to take early retirement.

So if you live in one the provinces with a pharmacare plan and are facing high drug costs, or you know someone who is, check out the plan and see if it can help you.

PHARMACARE: A NOTE ON QUEBEC

In my article on provincial pharmacare programs, I inadvertently failed to include the Quebec Prescription Drug Insurance Plan, introduced in 1997. Quebec residents who are not covered by a group drug plan can register with the Government for this plan.

Each registered adult must pay a premium of between 0 and $385 a year, depending on income. The premium is calculated and collected when income tax returns are filed. Children under 18, people receiving social assistance, or with other functional problems, are exempted from the annual premium.

In addition, plan members must pay a monthly deductible of $8.33 and co-insurance of 25% of monthly drug costs over $8.33 a month, to a maximum of $16.66 to $62.49 monthly, depending on income. Children, social assistance recipients and others with functional problems are also exempted from the deductible and co-pay requirements.

If you are a Quebec resident lacking group prescription drug insurance coverage and have significant drug costs, it makes sense to register for the Quebec Government plan. You can get more information from the Régie de l’assurance maladie du Québec.
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