Coverage of Methadose™ and Buprenorphine/Naloxone under Plan G

Effective February 1, 2017, PharmaCare covers Methadose™ for maintenance and buprenorphine/naloxone (Suboxone® and generics) under the Psychiatric Medications Program (Plan G). By covering these drugs under Plan G, PharmaCare coverage may be available to more individuals with lower incomes.

Full coverage for Methadose™ for maintenance and buprenorphine/naloxone was already available to individuals receiving B.C. Income Assistance (i.e. those covered under Plan C) and to those who do not have a deductible or family maximum under Fair PharmaCare.

By including these products under Plan G, coverage is also be available to those not covered by Plan C or those with a deductible or family maximum under Fair PharmaCare, and who meet the eligibility criteria for Plan G.

Plan G Eligibility

Plan G provides coverage under the following circumstances:

  • The individual attests that
    •  the cost of prescribed psychiatric medication is a significant barrier to taking their medication, and
    • they have no other financial coverage, and
    • they believe they qualify for Medical Services Plan (MSP) Premium Assistance 
      • MSP Premium Assistance is available to those with a family adjusted net income of up to $42,000 plus $3,000 per dependent.
         
  • The individual’s physician or nurse practitioner certifies that
    • the patient has been hospitalized for a psychiatric condition, and/or 
    • without prescribed medication, the patient is likely to be hospitalized for a psychiatric condition, and/or
    • without prescribed medication, the patient or another person is likely to suffer serious physical harm, psychological harm, or economic loss.

Applying for Plan G

Individuals can speak to their physician, nurse practitioner, Mental Health and Substance Use Centre, or Child and Youth Mental Health Centre about applying for Plan G coverage. If they are eligible, the physician or nurse practitioner can apply on the patient’s behalf by completing an Application for PharmaCare Plan G (HLTH 3497). Plan G coverage is approved for a period of time (usually 1 year), after which the physician or nurse practitioner can re-apply for continued coverage, if required.

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