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7.4 Income Assistance (Plan C)

Last updated on April 17, 2024

General Policy Description

Plan C provides drug and limited medical supply/device coverage for those receiving income assistance through the B.C. Ministry of Social Development and Poverty Reduction, and for children and youth in the care of the Ministry of Children and Family Development (including children and youth who are in care by agreement).

Policy Details

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Eligibility

Recipients of assistance (Income Assistance, Disability Assistance, Hardship Assistance and Health Supplements) registered for Plan C by the Ministry of Social Development and Poverty Reduction receive 100% coverage of eligible prescription costs.

Children and youth in care, youth in Youth Agreements, and children and youth in Extended Family Program Agreements registered for Plan C by the Ministry of Children and Family Development receive 100% coverage of eligible prescription costs.

The Ministry of Social Development and Poverty Reduction can confirm two types of PharmaCare benefits:

  • Ongoing Plan C (for recipients of Income Assistance, Disability Assistance, Hardship Assistance and Health Supplements) coverage
  • Emergency Plan C assistance (maximum 48 hours).

The Ministry of Children and Family Development can confirm

  • Plan C coverage for children and youth in care and youth in Youth Agreements up to when the child or youth turns 19 years of age
  • Plan C coverage for children and youth in Extended Family Program Agreements for a maximum of 30 months (children and youth supported through Extended Family Program Agreements are not extended past their 19th birthday
  • Emergency Plan C assistance (maximum 48 hours)

PharmaCare cannot confirm Plan C coverage.

Plan C coverage is not extended to patients in acute or extended care hospitals or to those already covered under PharmaCare Plan B (Permanent Residents of Licensed Long-term Care Facilities).

The full terms of eligibility for Plan C are described in Section 36 of the Drug Plan Regulation of the Pharmaceutical Services Act. The Ministry of Social Development and Poverty Reduction or the Ministry of Children and Family Development is responsible for determining individual eligibility for Plan C.

 

What is covered?

Under Plan C, PharmaCare pays 100% of eligible drug and dispensing fee costs up to the maximum cost and dispensing fee recognized by PharmaCare.

 

Coverage start date

The Ministry of Social Development and Poverty Reduction or the Ministry of Children and Family Development confirms eligibility and transmits Plan C coverage information in real-time to PharmaNet. Coverage is in effect from the time it is received by PharmaNet.

Plan C coverage cannot be provided retroactively.

 

Emergency assistance

When the Ministry of Social Development and Poverty Reduction or the Ministry of Children and Family Development grant emergency assistance, the person may qualify for temporary PharmaCare assistance for up to a maximum of 48 hours. The coverage is the same as that available under Plan C ongoing coverage.

Eligibility information is provided to PharmaCare by the Ministry of Social Development and Poverty Reduction and the Ministry of Children and Family Development. It is in effect from the time it is entered in PharmaNet.

Emergency coverage cannot be provided retroactively.

 

Procedures for Pharmacists

Processing new Plan C patients

Eligibility is entered into the Ministry of Social Development and Poverty Reduction and Ministry of Children and Family Development database. The Ministry of Social Development and Poverty Reduction gives a form to the client.

To process a new Plan C patient

  1. View the patient’s Ministry of Social Development and Poverty Reduction form or the child or youth’s BC Services Card to confirm the PHN.
  2. Check the patient's identification.

    Refer to Section 9.1—Positive Identification of Patients.
  3. Process the prescription using the PHN on the presented form or BC Services Card.
  4. Return the form or BC Services Card to the patient.

Plan C assistance not in place

Occasionally, the system interface with the Ministry of Social Development and Poverty Reduction fails to transmit patient information to PharmaNet and the PharmaNet transaction will not provide the expected adjudication results.

  1. Call the PharmaNet Help Desk.

    The Help Desk will contact the Ministry of Social Development and Poverty Reduction to have them confirm active coverage. If coverage is confirmed, the Help Desk enters short-term assistance in PharmaNet to allow for prescription processing under Plan C.
     
  2. On receiving confirmation that short-term assistance is in place, process the prescription as usual.
  3. Refer the patient to the local Ministry of Social Development and Poverty Reduction office to ensure ongoing coverage has successfully been registered in PharmaNet.

Tools and Resources

For more information on benefits, contact the local office of the Ministry of Social Development and Poverty Reduction or the local office of the Ministry of Children and Family Development.