5.4 Travel Supply Policy

General Policy Description

Under the Refilling Prescriptions Too Soon Policy, PharmaCare does not cover prescription refills when the patient has more than a 14-day supply remaining from a previous fill. Under the Travel Supply Policy, once every six months (180 days), a patient can request an exception to the Refilling Prescriptions Too Soon Policy to permit an early prescription refill for the purpose of travel outside B.C.

 Such refills are limited to “topping up” the remaining prescription supply to the maximum days’ supply recognized by PharmaCare for the drug.

Policy Details

Patients are eligible for an early “top-up” refill under the Travel Supply Policy once every six months (180 days).

PharmaCare covers travel supplies only up to the recognized PharmaCare maximum days' supply for the drug. Therefore, refills under the Travel Supply Policy are limited to the supply required to “top‑up” the remaining patient supply of the drug to the maximum days’ supply recognized by PharmaCare for that drug. For example, if the patient has 50 days’ supply remaining of a drug subject to a 100 day supply maximum, a travel supply refill is limited to a 50 day supply.

Patients requesting and receiving more than the recognized PharmaCare maximum days’ supply will be responsible for the cost of the supply exceeding the PharmaCare maximum days’ supply. For patients covered by Fair PharmaCare, only the portion of the costs eligible for PharmaCare coverage will count towards the deductible and/or family maximum.

Patients must complete and sign a Travel Declaration Form on the date the travel supply is filled in order to receive coverage for a travel supply refill. A parent or guardian can complete the Travel Declaration Form for a child’s prescription. Travel Declaration forms are supplied by the pharmacy.

Only one Travel Declaration form is needed to document travel supply claims for multiple drugs filled on the same day. When claims for a single patient are filled on separate days, a new Travel Declaration form will be required for each day on which travel supply claims are filled.

Pharmacies are to maintain completed Travel Declaration forms on file for audit purposes.

Pharmacies are to process travel supply claims using the intervention code “MV–Vacation Supply.

The MV intervention code is to be used only for travel supply claims for individuals travelling outside B.C.

Travel supply claims are not eligible for a Special Services Fee.

 

Procedures

Procedures for pharmacists

If PharmaNet refuses coverage of a refill because the patient has more than a two-week supply of medication left, ask the patient if the early refill is for travel outside B.C. and inform them of the Travel Supply Policy if it is.

If the patient requests an exception under the Travel Supply Policy,

  • Have the patient complete and sign a Travel Declaration form.
    A parent or guardian can complete the Travel Declaration for a child’s prescription.
  • Reverse the claim and re-submit it with the intervention code "MV–Vacation Supply."
    The claim will adjudicate to allow coverage of a top-up to the PharmaCare maximum days' supply for the drug.
  • Retain the signed Travel Declaration form for audit purposes.

If you enter a claim using the "MV–Vacation Supply" intervention code and receive the response "65‑Intervention/Exception Code Error," it indicates that the patient has less than a 14-day supply and that the claim can, and should, be entered without the MV intervention code.

The MV code is required only if the patient has more than a 14-day supply.

Enter the claim with the intervention code "DE – Adjudicate to $0.00 as requested." The patient will be responsible for the cost and, if they are on the Fair PharmaCare plan, the cost will not count towards their deductible and/or family maximum.

If the MV–Vacation Supply intervention code is entered in a claim along with any one of the following intervention codes, the claim adjudicates according to the non-MV intervention code.

  • MP–Valid Claim–Value $1000.00 to $9999.99
  • MR–Replacement, Item Lost or Broken
  • MX–LTC Prescription Order
  • MY–LTC Prescription Split for Compliance
  • UA–Consulted Prescriber & filled Rx As Written
  • UF–Patient Gave Adequate Explanation & Filled As Written
  • DE–Adjudicate to $0.00 As Requested

When a claim is submitted with the MV intervention code and an intervention code not noted above, the claim adjudicates as a Travel Supply under the MV code.

 

Questions and Answers

There is no change to the current policy regarding coverage for non-residents. PharmaCare ceases to cover a person's medication as soon as they move outside B.C.

Travel Declaration forms can be requested through Health Insurance BC.