Plan W OTC drug list

Last updated on April 4, 2025

Plan W 100% of the eligible costs of the items in the table below. When a pharmacist recommends or prescribes an OTC for a Plan W client, they must enter it in PharmaNet and record it on the Plan W OTC Recommendation form (PDF, 548KB) or, if associated with MACS, ONLY on the MACS Form (PDF, 705KB). Neither form is required for insulins or Plan W Non-Drug OTC benefits.

This list is updated every six months. It is also available as a PDF: Plan W OTC drug list PDF (493KB).

Transitional payment request

FNHA aims to support clients with access to continuity of ongoing therapy and immediate coverage of acutely needed items. The transitional payment request is a manual claim process for coverage of a one-time fill of an urgently needed product in cases of a coverage issue that is expected to be resolved soon, such as situations where a client's FNHA enrolment or Special Authority coverage request is pending.

The healthcare provider should provide the client with the product at no cost and bill FNHA using the FNHA Transitional Payment Request form (PDF, 201KB). The completed form, along with supporting documentation, should be faxed to FNHA at 1-888-299-9222.  

FNHA will reimburse pharmacists a $10 service fee for supporting the client in addition to the usual maximum drug cost and dispensing fee. The form can also be used to request transitional coverage for medical supplies and equipment that are urgent and eligible for coverage. The PIN 36420005 – TCR payment will show on the pharmacy payment statement from Pacific Blue Cross. 

If an FNHA client does not have Plan W as their primary drug plan, the pharmacist can support the client by submitting a transitional payment request with the client’s PHN, Status Number, DOB and contact information, indicating that the client requires Plan W enrolment. In this scenario, FNHA will reimburse pharmacists a $10 service fee. The PIN 36420006 – MSP enrolment payment will show on the pharmacy payment statement from Pacific Blue Cross. 

Quick Links: Summary of pharmacy resources

The Quick Links: Summary of pharmacy resources (PDF, 121KB) has a list of resources to support the delivery of services to FNHA clients.