Ostomy Supplies PINs
The ostomy supplies listed below are covered for eligible patients who have undergone bowel and/or bladder surgery that results in a colostomy, ileostomy, or urostomy, requiring an external pouch. Actual reimbursement is subject to the rules of the patient’s PharmaCare plan, including any deductible requirements.
Note: PharmaCare covers certain ostomy supplies for First Nations Health Authority clients under Plan W (see list below). The Non-Insured Health Benefits (NIHB) program may still cover some supplies not eligible under Plan W which may require NIHB prior authorization.
PIN |
PRODUCT |
PRODUCT EXAMPLES/NOTES* |
---|---|---|
88123418 |
Ostomy pouch – drainable |
Coloplast Sensura pouch #10471 |
88123420 |
Ostomy pouch – closed |
Hollister Center Point Lock pouch #3347 |
88123431 |
Ostomy pouch – urostomy |
Coloplast urostomy pouch #5570 |
88123443 |
Stoma caps, colostopads |
Hollister #1796 |
88123455 |
Ostomy flanges and convex inserts |
Coloplast Assura flange #14246 |
88123467 |
Colostomy irrigation sets |
ConvaTec #1916 |
88123479 |
Colostomy irrigation cone, tip, faceplate, sleeves |
ConvaTec VisiFlow cone , Hollister sleeves #7728 |
88123480** |
Urostomy night drainage sets |
ConvaTec #27060 |
88123492** |
Urostomy tubing and adaptor |
ConvaTec Accuseal adaptor |
88123510** |
Urostomy leg bag and straps |
Hollister #9825 |
88123522 |
Tape for securing the edges of an ostomy pouch— paper type only |
3M paper tape |
88123534 |
Ostomy skin barriers |
Eakin seals #83900, Hollihesive skin barriers |
88123642 |
Ostomy barrier strips/extenders |
Coloplast Brava elastic barrier strip, Brava elastic tape straight, Brava elastic tape belt, SALTS flange extender with aloe, Hollister Adapt barrier extender |
88123546 |
Skin care wipes, sprays and adhesive removers |
Hollister skin gel wipes, ConvaTec All Kare wipes |
88123558 |
Ostomy paste, cement and powder |
Stomahesive powder #5507, Hollister Adapt paste #9301 |
88123560 |
Ostomy accessories—belt (excluding ostomy support belts), belt rings, closures, filters, and guide strips |
Hollister filters #7766, ConvaTec belt #175507 |
88123571 |
Ostomy adhesive spray |
Hollister 7730 |
88123583 |
Tincture of benzoin |
|
88123595 |
Ostomy pouch – reusable style |
Marlen Neoprene, Permatype, Torbot |
88123625 |
Faceplates for reusable ostomy pouches (i.e., faceplates for PIN 88123595 above) |
Permatype, Marlen |
88123637 |
Internal deodorants (oral tablets) |
200mg capsules of bismuth subgallate |
*Products in the right-hand column are examples only. Their inclusion is not an endorsement of these products. Coverage is not limited to these products or manufacturers.
**These items are covered only for patients using Ostomy Pouch – Urostomy (PIN 88123431)
Non-benefit Items
The following items are not benefits.
Note: Exclusion of a product from this list does not imply it is a benefit product.
- Catheters—for any use, including
- for management of any medical or post-surgical condition
- all products for management of continent urostomies—catheters, absorbent pads
- Note: PINs 88123480, 88123492 and 88123510 are benefits for patients using a urostomy pouch (PIN 88123431)
- All products for the management of nephrostomy tubes, feeding tubes, other drainage tubes, wound drainage—such as Hollister drain tube attachment device, or urinary drainage collection equipment (including PINs 88123480, 88123492 and 88123510, except as noted above)
- All products for management of urinary incontinence—catheters, condoms, drainage containment equipment, diapering systems, incontinence pads, tubing and adapters (including PINs 88123480, 88123492 and 88123510, except as noted above)
- Cotton covers for pouches or night drainage bottles
- Pouch liners—such as Colo-Majic
- Stoma hole cutters
- Ostomy support belts—such as Nu-Hope
- Skin protectants—such as Marathon skin protectant
- Creams—such as Sween Cream, Chiron Cream, BAZA cream
- Cleansers—such as Uni-Wash, ConvaTec AloeVesta products
- Lubricants—such as KY Jelly, Hollister stoma lubricant
- Tapes (other than paper-type or elastic barrier tape)—such as waterproof tape, Elastoplast, straight transparent dressings—such as OpSite, Tegaderm
- Room deodorants—such as M9
- In-pouch deodorants—such as Uri-Kleen, M9, Banish
- Hydrocolloid dressings—such as DuoDerm, Restore, Tegasorb
- Instruments—such as scissors, dressings sets
- Alcohol swabs, sterile and unsterile gauze
- Any items purchased through online suppliers – items must be purchased from authorized PharmaCare providers.
PharmaCare does not cover any items, even if they are listed in this document, not used for the purposes stated. Non-benefit uses include management of a catheter, diabetes, an insulin pump, wounds, ineligible types of ostomy (e.g., a cecostomy or nephrostomy), feeding tubes, or urinary incontinence.