Fair PharmaCare Plan

What is Fair PharmaCare?

Fair PharmaCare helps B.C. families pay for eligible prescription drugs, dispensing fees and some medical supplies.  To register for Fair PharmaCare, families must have Medical Services Plan (MSP) coverage. Fair PharmaCare is income-based; the less a family earns, the more help they get.

Who is Eligible for Fair PharmaCare?

All residents of B.C. are eligible for Fair PharmaCare coverage if they:

  • Have Medical Services Plan (MSP) coverage, and
  • Give PharmaCare permission to check their income with the Canada Revenue Agency. (Income is from two years prior.)

Coverage is for families, not individuals. A family can be a:

  • Single person
  • Married or common-law couple
  • Single person with dependent children
  • Couple with dependent children

The following people who may not have filed a tax return in Canada two years ago may need to supply more information:

  • New residents to Canada
  • British Columbians who have been living and working overseas
  • People turning 19, and
  • People who were exempt from filing a Canadian tax return.

If one or more family members do not meet the eligibility requirements, other family members can still register.

(See Families and Fair PharmaCare below for more information about dependent children.)

What does Fair PharmaCare Cover?

Fair PharmaCare covers:

  • Eligible prescription drugs
  • Some medical devices
  • Eligible dispensing fees and some pharmacy services (such as medication reviews for persons prescribed five medications or more)

Important: Fair PharmaCare does not cover costs from previous years, or from times when the family’s MSP coverage was not active.

For more information, please see What We Cover.

When does Fair PharmaCare coverage start?

Coverage begins as soon as PharmaCare processes your registration. If you register online or by phone, your coverage begins immediately.

You must provide consent to the Canada Revenue Agency (CRA) to allow CRA to share your income information with PharmaCare.

Your coverage is temporary until PharmaCare verifies your income with the CRA; then your coverage is set for the rest of the calendar year. As long as PharmaCare is able to verify your income each year with the CRA, your coverage continues.

PharmaCare will adjust your coverage based on the income information PharmaCare receives from the CRA each year.

What is a Deductible?

  • A family’s deductible is the amount they need to spend each year on eligible costs before Fair PharmaCare starts to help with these costs. Once they reach their deductible, PharmaCare pays 70% of costs; 75% of costs for families with a member born before 1940.

What is a Family Maximum?

  • The family maximum is the most a family will spend out of pocket, per year, on eligible drugs, fees, and medical supplies.
  • If a family reaches their family maximum, Fair PharmaCare then pays 100% of their eligible expenses for the rest of the year. 
  • You can calculate your family maximum using the Fair PharmaCare estimator.

ExampleHow Deductibles and Family Maximums Work

The Garcia family enrolls with Fair PharmaCare in January. Their family income is $30,589. The Garcia family pays the full price for each eligible drug, dispensing fee and medical supply until they reach their deductible.

The Garcias’ deductible is $650.

Between January and May, the Garcias fill prescriptions that cost $650. They pay the full cost of the prescriptions.

The family has now met their Fair PharmaCare deductible.

 

Between June and September, the Garcia family needs another $833 of eligible drugs and dispensing fees.

PharmaCare pays $583 (70% of $833). The Garcias pay $250.

The $250 is added on to their deductible amount of $650. This brings the total amount they have spent on eligible prescriptions to their family maximum of $900.

PharmaCare now pays 100% of the Garcias’ eligible costs for the rest of the year.

In January of the next year, their deductible is reset to $650, and the Garcias again pay the full amount for their eligible prescriptions, until they have met their deductible.

If the Garcias know that their prescriptions will cost more than their deductible for the year, they can sign up for the Monthly Deductible Payment Option and PharmaCare will help with their prescription costs immediately.

Families and Fair PharmaCare

Dependent children who receive Fair PharmaCare coverage are:

  • Under the age of 19
  • 19-24 and attending school full time
  • Included on their parents' MSP plan (In the case of shared custody, they belong to only one parent’s MSP plan)  
  • Not married or living in a marriage-like relationship

Children who are not considered dependent:

  • Can register for Fair PharmaCare on their own plan once they turn 19  
  • Will receive a letter from MSP when they turn 19 informing them of their MSP premiums and asking them to register for Fair PharmaCare

Note: people aged 19 and over, and who are not full-time students, should register for their own Fair PharmaCare account. Their parents' incomes will not affect their deductible or family maximum, so they may be able to get more coverage.

Families with Private Health Insurance

Families with private health insurance may still get help with costs from Fair PharmaCare. For more information, please see Fair PharmaCare FAQ.

Register for Fair PharmaCare

You can register online or by phone. To register by phone from the Lower Mainland, call 604 683-7151, from the rest of B.C., call 1 800 663-7100. You can also register using by a paper form.

You will need:

  • For all family members:
    • Personal Health Number (found on the back of your driver’s license or BC Services Card)
    • Birth dates
  • For you and your spouse (if you have one):
    • Social Insurance numbers
    • Income from your tax return from two years ago, including:
      • Net income (line 236)
      • Any income from a Registered Disability Savings Plan (RDSP) (line 125)

Note:

  • Temporary coverage starts the same day you register via phone or online, based on the income information you provide.
  • After you register, PharmaCare will send you a consent form that you must fill in, sign, and send back within 30 days, so that we can check your income with the CRA.
    • If you do not return your CRA consent form, temporary coverage will end and your family's deductible will be set at $10,000.
    • It may take up to 90 days to confirm your income with the CRA.
    • Once we verify your income, PharmaCare will send you a confirmation letter within 30 days.
  • Lost your consent form? Get a copy from  the online Forms Copy Request or by contacting Health Insurance BC. Return the form as soon as possible to ensure temporary coverage continues.
  • Already Registered? Call Health Insurance BC if you have already registered, but no longer have coverage.