Plan Z (Assurance)

Last updated: July 27, 2023

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.

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:

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

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

Visit Contraceptives – Information for health professionals for the list of covered contraceptives and their PINs.

MAiD

Plan Z coverage

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

View 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).

Exceptional Plan Z coverage

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

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

Mifegymiso®

Plan Z coverage

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

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

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:

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

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 C and 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.

For Plan Z claims, visit the OAT PINs and DINs web page.

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:

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

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 are in the MSP coverage wait period, i.e., have completed 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

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)

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
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

 

The two steps of MSP enrolment

There are two steps of enrolling in MSP:

Active coverage starts once these steps are complete and the B.C. resident has completed the wait period consisting of the balance of the month in which residence in B.C. is established, plus two months. The wait period starts when residence in B.C. is established. For example, if someone enrols after the end of their wait period, their MSP enrolment will be active as soon as they complete both steps. 

Relevant forms

Resources