Plan Z (Assurance) and exceptional coverage

Last updated: March 9, 2023

Plan Z (Assurance) provides full coverage of any included product for any eligible beneficiary.

The Full Payment Policy applies to Plan Z. Providers may not charge patients any costs associated with the dispense of a Plan Z benefit.

On this page: Claims procedures | Exceptional Plan Z | Plan Z formulary | Resources and forms

Claims procedures

For Plan Z claim reimbursements, please use MAiD-specific PINs.

For non-PharmaCare-specific information, see Medical Assistance in Dying Information for Health Care Providers.

Note that pharmacists must submit the MAiD Dispensing Record (Pharmacist) (PDF, 707KB).

For Plan Z claim reimbursements, please use the DIN below.

PharmaNet entry for Mifegymiso
DIN 02444038
Strength / form 200 / 0.2 mg tablet
Drug cost $324.00
Plan Z and exceptional Plan Z

For Plan Z claim reimbursements, please use the PIN below.

PharmaNet entry for Paxlovid  
PIN 02524031 02527804
Strength / Form 300 / 100 mg tablet 150 / 100 mg tablet
Drug cost $0.01 $0.01
Plan Z and exceptional Plan Z Z and exceptional Plan Z

Beginning April 1, 2023, many contraceptives are fully covered for B.C. residents. These include a number of oral contraceptives, IUDs, implants and injections. All products need to be entered in PharmaNet by a pharmacist to be covered. Visit Contraceptives – Information for health professionals for more information, including the list of covered products.

 

Exceptional Plan Z

Exceptional Plan Z coverage is available in exceptional situations. Exceptional coverage requests are processed by PharmaCare Special Authority or Health Insurance BC, depending on the type of drug.

Requirements for exceptional coverage

Exceptional Plan Z coverage for Medical Assistance in Dying (MAiD) is available to patients in B.C. who are in the MSP wait period, or have public health insurance in another Canadian province or territory.


Procedure for exceptional coverage

The pharmacist contacts the HIBC help desk and provides the following:

  • College ID
  • Patient’s name, PHN, date of birth, and B.C. address

The pharmacist confirms:

  • The patient requires treatment in B.C.
  • The patient has current medical coverage in another Canadian province or territory
  • The patient’s out-of-province medical plan number (if available)

HIBC will complete the application for exceptional Plan Z MAiD coverage and send it to Special Authority.

Special Authority will activate coverage in PharmaNet and inform the pharmacy by fax.

 

Requirements for exceptional coverage

Exceptional Plan Z coverage for Mifegymiso is available to patients in B.C. who have completed the two-step MSP enrolment process (submitting the Application for Health and Drug Coverage (AHDC) and verifying ID at an ICBC driver licensing office) and are in the MSP wait period.


Procedure for exceptional coverage

The pharmacist must:

Special Authority will contact HIBC to confirm if the patient has completed both steps of MSP enrolment.

If HIBC confirms the patient’s eligibility:

  • Special Authority will activate 3 months of coverage in PharmaNet and will inform the pharmacy by fax

If HIBC confirms that the patient is not eligible:

  • Special Authority will mark the form with the reason for ineligibility and inform the pharmacy by fax

 

Requirements for exceptional coverage

Exceptional Plan Z coverage for Paxlovid is available to all patients receiving treatment in B.C. They may be in the coverage wait period for MSP, or they may be from out of province or out of country.


Procedure for exceptional coverage

The pharmacist contacts the HIBC help desk and provides the following:

  • College ID
  • Patient’s name, PHN (if applicable), date of birth, and B.C. address

The pharmacist will confirm:

  • The patient requires treatment in B.C.
  • The patient’s out-of-province medical plan number (if applicable)
  • The patient’s country of residence (if applicable)

HIBC will complete the application for exceptional Plan Z Paxlovid coverage and send it to Special Authority.

Special Authority will enter 3 months of coverage into PharmaNet and inform the pharmacy by fax.

 

 

Plan Z formulary

The table below lists Plan Z benefits. This list is for general reference only. It may not reflect the most recent changes to the Plan Z formulary. You can also use the PharmaCare Formulary Search. Click on "Assurance" under Select PharmaCare Plan or search by drug name or DIN.


PharmaCare formularies are not a replacement for professional medical judgment and advice.

Drugs and services covered by Plan Z Condition/procedure
contraceptives – refer to the list of covered contraceptives all indications
nirmatrelvir/ritonavir (Paxlovid) COVID-19
mifepristone/misoprostol (Mifegymiso) medical abortion
bupivicaine MAiD
clinical service fee for MAiD iv kit MAiD
clinical service fee for MAiD oral kit MAiD
haloperidol MAiD
lidocaine  MAiD
lorazepam MAiD
metoclopramide MAiD
midazolam MAiD
non-standard MAiD product MAiD
ondansetron MAiD
pb+chlorhyd+ms oral cpd susp MAiD
phenobarbital sodium MAiD
propofol MAiD
rocuronium bromide MAiD
secobarbital compound suspension MAiD
sodium chloride MAiD
tecovirimat mpox