3.6 Patients - With Out-of-Province/Country Prescriptions

General Policy Description

PharmaCare coverage is limited to medications prescribed by a practitioner licensed and practicing in Canada and dispensed at a B.C. pharmacy. Exceptions may be made for out-of-province dispenses in Canadian border communities (i.e., in Alberta, Yukon and Northwest Territories) for B.C. residents for whom the closest pharmacy is out-of-province. Some exceptions are also made for B.C. residents temporarily out of the province.

Policy Details

Out-of-province prescriptions

A B.C. pharmacist can dispense a prescription issued in another province if the pharmacist is confident that the prescription is valid.

Coverage for prescriptions for B.C. residents filled out-of-province

Border communities

B.C. residents who live near the provincial border may receive PharmaCare coverage for prescriptions filled by out-of-province (OOP) pharmacies. To be eligible, the OOP pharmacy must be enrolled as a PharmaCare provider. These claims must be submitted manually by the provider, as per Section 4.1 – Claims by Offline and Out-of-Province Providers. Payment is provided only when the OOP provider is closer to or more accessible from a B.C. resident’s home than the nearest B.C. pharmacy.

Temporary absences

PharmaCare does not cover prescriptions for patients temporarily out of the province, except:

• Claims meeting requirements under Section 5.4—Travel Supply Policy
• Medications and supplies purchased from a PharmaCare provider by a patient who continues to be a B.C. resident under the Drug Plans Regulation despite being temporarily absent
• Claims from patients covered under Plan W (First Nations Health Benefits). Out-of-province purchases of Plan W benefits may be reimbursed if the client submits a manual patient claim to PharmaCare
• Certain pre-approved out-of-province expenses when an individual requires treatment not available in B.C. (e.g., transplant procedures, when PharmaCare receives faxed notification of the surgery from BC Transplant Society)

Coverage of out-of-province medications and supplies remains subject to PharmaCare pricing policies and the usual rules of the patient's PharmaCare plan.

Requests for reimbursement for out-of-province purchases should be made in writing (and include supporting documents) to Health Insurance BC (HIBC). Review Section 4.2 – Manual Patient Claims.

​Out-of-country prescriptions

Prescriptions issued in another country (including the USA) cannot be dispensed by a B.C. pharmacist. This is prohibited by the Canada Food and Drugs Act.

Anyone, whether or not a Canadian resident, who holds a prescription written by an out-of-country practitioner may have the prescription dispensed by a B.C. pharmacist only if the prescription has been either:

• Rewritten, on the practitioner’s own prescription pad, by a practitioner licensed to prescribe in a Canadian jurisdiction, or
• Co-signed by a Canadian practitioner