Plan Z (Assurance)

On this page: Contraceptives | MAiD | Mifegymiso | Opioid agonist treatment (OAT) | Paxlovid | Tecovirimat | Plan Z formulary

Plan Z (Assurance) provides full coverage of any included product for any eligible beneficiary. The Full Payment Policy applies to products on Plan Z, other than those identified as partial benefits.

Exceptional Plan Z coverage is available for some products, for people who are not enrolled in MSP.

Contraceptives

Plan Z fully covers many contraceptives for B.C. residents enrolled in MSP.

These include oral contraceptives; intrauterine devices (IUDs); an implant; an injection; and emergency oral contraceptives. Products must be entered in PharmaNet by a pharmacist to be covered.

View list of covered contraceptives and PINs at Contraceptives – Information for health professionals.

Exceptional Plan Z coverage

Exceptional Plan Z coverage of contraceptives is available to B.C. residents who have completed both steps of MSP enrolment but are still in the wait period/not yet actively enrolled.

How to apply for exceptional coverage of contraceptives

The pharmacist must:

• Confirm with the patient that they have completed the two MSP enrolment steps
• Complete and fax the Application for Exceptional Plan Z Coverage for Contraceptives (PDF. 678KB) to Special Authority (SA) at 1-855-812-1071

If patient is eligible:

• 3 months of coverage will be activated in PharmaNet, and
• The form will be faxed back to the pharmacy with the coverage dates

If patient is not eligible:

• The form will be faxed back to the pharmacy with the reason for ineligibility

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MAiD

Plan Z coverage

Plan Z fully covers MAiD for B.C. residents enrolled in MSP.

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).

View MAiD-specific PINs.

Exceptional Plan Z coverage

Exceptional Plan Z coverage for MAiD is available to patients in B.C. who:

• Have completed both steps of MSP enrolment but are in the wait period, or
• Are new to B.C. and have public health insurance in another Canadian province or territory

Procedure for exceptional coverage for MAiD

The pharmacist contacts the HIBC help desk and provides:

• 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 medical coverage in another Canadian province or territory
• The patient’s out-of-province medical plan number (if available)

If patient is eligible:

• 3 months of coverage will be activated in PharmaNet, and
• The form will be faxed back to the pharmacy with the coverage dates

If patient is not eligible:

• The form will be faxed back to the pharmacy with the reason for ineligibility

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Mifegymiso^®

Plan Z coverage

Plan Z fully covers Mifegymiso for B.C. residents enrolled in MSP.

View Mifegymiso DIN and procedures. 

Exceptional Plan Z coverage

Exceptional Plan Z coverage for Mifegymiso is available to patients in B.C. who have completed both steps of MSP enrolment but are still in the wait period/not yet actively enrolled.

Procedure for exceptional coverage for Mifegymiso

The pharmacist must:

• Confirm with the patient that they have completed the two MSP enrolment steps
• Complete the Application for Exceptional Plan Z Coverage eForm (preferred). Or complete and fax the PDF version (PDF, 505KB) to Special Authority at 1-855-812-1071

If patient is eligible:

• 3 months of coverage will be activated in PharmaNet, and
• The form will be faxed back to the pharmacy with the coverage dates

If patient is not eligible:

• The form will be faxed back to the pharmacy with the reason for ineligibility

PharmaNet entry for Mifegymiso

DIN	02444038
Strength / form	200 / 0.2 mg tablet
Drug cost	$324.00
Plan	Z and Exceptional Plan Z

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Opioid agonist treatment (OAT)

Plan Z coverage

Plan Z covers opioid agonist treatment (OAT) for B.C. residents enrolled in MSP.

OAT regular benefit products are covered under 100% coverage plans B, C, G, as well as Z.

OAT non-benefit products may be considered for exceptional, last-resort coverage with a Special Authority application under plans C, G, W, as well as Z.

Visit OAT PINs and DINs 

Exceptional Plan Z coverage

To ensure continuity of care and harm reduction, exceptional Plan Z coverage is available for OAT for B.C. residents who:

• Have not yet enrolled in MSP, or
• Have completed both steps of MSP enrolment but are in the wait period

Procedure for exceptional coverage for OAT

Exceptional coverage can be initiated in two ways: by a prescriber or pharmacist:

1. The prescriber or pharmacist faxes the completed Application for Exceptional Plan Z Coverage for OAT (PDF) to HIBC.

• HIBC will review the form and send it to Special Authority. If patient is eligible, 6 months of coverage will be activated in PharmaNet, and
• The form will be faxed back to the pharmacy with the coverage dates
• Special Authority will enter 6 months of coverage into PharmaNet and inform the pharmacy by fax

2. The prescriber or 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 or prescriber will confirm:

• The patient requires treatment in B.C.
• The patient’s out-of-province medical plan number (if applicable)
• The patient has been informed that they must enrol in MSP if they are remaining in B.C.

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

If patient is eligible:

• 6 months of coverage will be activated in PharmaNet, and
• The form will be faxed back to the pharmacy with the coverage dates

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Paxlovid^™

Plan Z coverage

Plan Z fully covers Paxlovid for B.C. residents enrolled in MSP.

Exceptional Plan Z coverage

Exceptional Plan Z coverage for Paxlovid is available to all patients receiving treatment in B.C., who have completed both steps of MSP enrolment, i.e., submitted the Application for Health and Drug Coverage and presented ID at an ICBC driver licensing office, or who live outside of B.C. or Canada.

Procedure for exceptional coverage for Paxlovid

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)

If patient is eligible:

• 3 months of coverage will be activated in PharmaNet, and
• The form will be faxed back to the pharmacy with the coverage dates

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Tecovirimat (TPOXX™)

Refer to guidance for the treatment of monkeypox (PDF, 304KB) for process and procedures of oral tecovirimat (TPOXX™).

For ambulatory patients, tecovirimat must be dispensed by the Product Distribution Centre and documented in PharmaNet.

Plan Z coverage is available for out-of-province patients, or for those in the MSP coverage wait period.

To apply, the prescriber or pharmacist contacts the HIBC help desk and provides the following:

• College ID
• The patient’s name, PHN (if applicable), date of birth and address

The pharmacist or prescriber will confirm:

• 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 applicable)

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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.

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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
opioid agonist treatment (OAT) – refer to OAT PINs and DINs web page	OAT
pb+chlorhyd+ms oral cpd susp	MAiD
phenobarbital sodium	MAiD
propofol	MAiD
rocuronium bromide	MAiD
secobarbital compound suspension	MAiD
sodium chloride	MAiD
tecovirimat	mpox