Benefit Groups

Eligibility Process

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 & UK

CF

Registered Cystic Fibrosis Clients - eligible under Plan D

Supplements & Enzymes Identification Numbers

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

Diabetic Supplies Identification Numbers

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

Special Authority Categories

MH

Psychiatric Medications - eligible under Plan G
Psychiatric Medications Formulary

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

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

Prosthetic & Mastectomy Product Identification Numbers
Ostomy Product Identification Numbers

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

Trial Prescription Program

U

Fair PharmaCare clients - eligible under Plans I0-9, IA-IZ, 1I-4I, J0-J9, JA-JZ, 1J-2J, Q, & UI