Albertans are responsible for the cost of prescription drugs to them outside hospitals, auxillary hospitals and nursing homes. Alberta Health and Wellness contracts with Alberta Blue Cross to offer three supplementary drug plans:

General:

• Non-Group Coverage
• A universal prescription drug plan available to all Alberta residents under the age of 65 years and their dependants
• Must be an Alberta resident, under the age of 65 years, registered with the AHCIP and have not opted out of the plan and not in arrears for AHCIP
• Coverage will become effective on the first day of the fourth month after application received
• Program covers 70% of cost of prescription drugs
• Co-payment - 30% of cost, to a maximum of $25, for each drug prescribed
• Alberta Blue Cross premiums on a quarterly basis
• Seniors
• Coverage for Seniors - for Albertans 65 years of age and older and their dependants, and recipients of the Alberta Widows' Pension and their dependants
• Special Needs
• Palliative Care Drug Coverage - for people diagnosed as being palliative and receiving their treatments at home

Premium Subsidy
Income levels for the Full Premium Subsidy Program and Full Premiums:
Full Subsidy
Single: <$17,450
Family/No Children: <$26,200
Family/With Children: <$32,210

Full Premium:
Single: >20,970
Family/No Children: >33,240
Family/With Children: >39,250

Drug Subsidy
Alberta Blue Cross premiums (payable quarterly)
Regular Premium: Single/$61.40 and Family/$123
Subsidized Premium: Single/$43.05 and Family/$86.10

* those who qualify for AB Health Care Insurance subsidy will qualify for subsidized Alberta Blue Cross non-group premiums

The Fair PharmaCare Program provides financial assistance based on net family income to British Columbia residents for eligible prescription drugs and designated medical supplies. Program pays:

General:

• 70% of the family's eligible drug costs for the year, once the deductible is reached
• Once the family maximum is reached, PharmaCare covers 100% of the family's eligible drug costs for the remainder of the year
• Deductible and family maximum are based on income bands

Those born 1939 or earlier
Pharmacare provide immediate financial assistance if net family income falls below $33,000 (lowest income range)

• No deductible
• Pharmacare pays 75% of eligible prescription drug costs
• Family maximum after which 100% of drug costs are covered equal to 1.25% of net income

All others
Pharmacare provides immediate financial assistance if net family income falls below $15,000 (lowest income range)

• No deductible
• Pharmacare pays 70% of eligible prescription drug costs
• Family maximum after which 100% of drug costs are covered equal to 2% of net income

Additonal benefits available from PharmaCare:

• Residents of licensed long-term care facilities Plan B
• People receiving income assistance through the Ministry of Employment and Income Assistance Plan C
• Individuals registered with a provincial Cystic Fibrosis Clinic Plan D
• Children eligible for medical or full financial assistance through the At Home Program of the Ministry of Children and Family Development Plan F
• Clients eligible for financial assistance through mental health centres Plan G
• Patients eligible for financial assistance under the Palliative Care Drug Plan

General:
Annual Pharmacare deductible based on annual family income

• Once deductible reached, Pharmacare pays 100% of eligible prescription drugs

Special Needs

• Programs also available for social assistance recipients, residents of personal care homes and terminally ill

New Brunswick Prescription Drug Program (NBPDP) provides prescription drug benefits to a number of eligible beneficiary groups.
NBPDP reimburses drugs dispensed in New Brunswick by a pharmacist or designated dispensing physician.

Plan A - Seniors:

• This plan is for New Brunswick residents who are 65 years of age and older who receive the Guaranteed Income Supplement (GIS) or who qualify for benefits based on an annual income as follows:
• A single senior with an annual income of $17,198 or less
• A senior couple with one spouse over 65, with a combined annual income of $26,955 or less
• A senior couple with one spouse under 65, with a combined annual income of $32,390 or less
• Seniors receiving the GIS are required to pay a co-payment charge of $9.05 for each prescription, up to a maximum of $250 in one calendar year
• Those seniors who qualify based on their total annual income are required to pay a co-payment of $15.00 per prescription
• A qualification package is automatically sent to every New Brunswick residents 60 days before their 65th birthday

Other Beneficiary groups include:

• B (Cystic Fibrosis)
• E (Family and Community Social Services - individuals residing in licensed residential facility)
• F (Family and Community Services)
• G (Special needs children and children in care of the Minister of Family and Community Services)
• H (Prescriptions written by a neurologis for specific medications)
• R (Organ Transplant)
• T (Human Growth Hormone)
• U (HIV)
• V (Nursing Home)

The Newfoundland and Labrador Prescription Drug Program comprises three programs:
General

• The Income Support Program
• Provides prescription drug coverage, for identified benefit agents, for residents of the province who qualify for full benefit coverage under the Department of Humans Resources and Employment
• Provides for prescription drug coverage, for identified benefit agents, for residents who, due to the high cost of their medications, may qualify for drug card only benefits
• Provides 100% coverage of the ingredient cost, up to a 10% markup where ingredient cost exceeds $30.00, and a maximum dispensing fee of $6.50

Seniors

• The Seniors Drug Subsidy Program
• Provides prescription drug coverage, for identified benefit agents, for residents who are 65 years of age or over, who are in receipt of the GIS and who are registered for the OAS benefits
• Provides coverage of defined ingredient cost only for identified benefits. The remaining cost paid by the senior as co-payment. Amount is not regulated by government

Special Needs

• Special Needs Program
• Provides universal coverage for patients with Cystic Fibrosis and Growth Hormone
• Universal coverage provided for Food Bank clients but must apply for coverage under the Dept of Human Resources and Employment once they reach 18 years of age, at which time access to the program is based on financial need
• Provides 100% coverage for identified benefits - disease-related prescription drugs, enzymes, foods, medical supplies, and equipment
• Supplied through the Health Sciences Central Supply and Pharmacy

Alberta Blue Cross administers the following programs on behalf of the Government of the NWT:

• Métis Health Benefits
• Prescription Drug and Dental Benefits for Seniors
• Prescription Drug Benefits for Specified Medical Conditions

Prescription Drug Benefits for Seniors:

• Program provides up to 100% coverage for eligible prescription drug products in the NWT Drug Listing, when the drug is prescribed by a health care professional and dispensed by a licensed pharmacist

Nova Scotia Pharmacare Programs - programs and funding (commonly referred to as Pharmacare) include:

• The Seniors' Pharmacare Program
• The Community Services Pharmacare Programs
• Drug Assistance for Cancer Patients
• Multiple Sclerosis drug funding

Pharmacare pays for drugs and supplies listed as benefits in the Nova Scotia Formulary. Drugs and supplies must be prescribed by a doctor, dentist, authorized optometrist, or authorized nurse practitioner and you must have the prescription filled by a Nova Scotia pharmacy, to be paid for by Pharmacare.

• Seniors pay a yearly premium and co-payment for prescribed drugs
• Premium is $424 a year
• Co-payment is 33% of the total prescription cost to a maximum of $30 for each prescription with an annual maximum of $382
• Minimum co-payment of $3.00 per prescription
• Once $382 co-payments paid, Pharmacare covers prescriptions at 100%
• Fiscal year for co-payments is April 1 to March 31st
• Pharmacare pays for drugs and supplies listed as benefits in the Nova Scotia Formulary
• Drugs and supplies must be prescribed by a doctor, dentist, authorized optometrist, or authorized nurse practitioner and must have the prescription filled by a Nova Scotia pharmacy
• Some exceptions apply
• Programs also available for income assistance recipients, cancer and multiple sclerosis patients

Low-income seniors who do not receive the GIS may qualify for reduced Pharmacare premiums if:

• You are single, and your income is < $24,000 per year
• You are married, and your combined income is < $28,000

• Seniors and persons with chronic illness may obtain some coverage for drugs and medical supplies through the Extended Health Program
• Inuits eligible for coverage through Health Canada
• No covereage for Non-Inuits

General/Senior
Ontario Drug Benefit (ODB) program for all persons who receive social assistance through the Ontario Works program or the Ontario Disability Support Program, residents of long-term care facilities or homes for special care, or persons who are over the age of 65. The program provides reimbursement for the cost of pharmaceutical products, listed on the program's drug formulary.

Ontario residents eligible for this program if belong to one of the following groups and have valid OHIP:

• People 65 years of age and older
• Residents of long-term care facilities
• Residents of Homes for Special Care
• People receiving professional services under the Home Care program
• People receiving social assistance

Up to $2 per prescription for

• Single senior with annual net income <$16, 018
• Senior couple with combined annual income <$24, 175
• Receiving Ontario Works benefits or Ontario Disability Support benefits
• Receiving homecare professional services
• Resident of a nursing home, home fo rthe aged, home for special care
• A Trillium Drug Program beneficiary

First $100 in prescription drug costs each year and then up to $6.11 per prescription for

• Single seniors with annual net income >$16, 018
• Senior couples with combined annual net income of more than $24, 175

Trillium Drug program provides benefits for each fiscal year in which prescription drug costs exceed a certain proportion of income for those not receiving prescription drugs through the ODB program or whose private insurance does not cover all of their health costs.

Special Drugs Program

• ODB eligible people may pay some portion of prescription drug product costs as follows:
• Single people aged 65 or older who have an annual income of $16,018 or more
• Seniors couples with a combined annual income of $24,175 or more pay a $100 deductible per senior before being eligible for drug coverage
• After these seniors pay deductible, then pay up to $6.11 toward the dispensing fee each time a prescription is filled for a covered drug product in Ontario in the benefit year
• All other ODB eligible people, including Trillium Drug Program recipients, may pay up to $2 each time prescription filled
• Trillium Drug Program applicants must also pay quarterly or prorated deductible that is based on income before being eligible to receive drug coverage
• Benefit year for all ODB recipients starts on August 1 and ends on July 31 of the following year

A Drug Cost Assistance Plan for seniors is open to residents age 65 and over on application. The Seniors Program pays the full cost for eligible prescriptions minus a $11 co-payment and the senior must also pay the dispensing fee.
The Family Health Benefit program assists lower income families with the cost of prescription drugs. Families with at least one child under age 18 with a total annual income less than $22,000 are eligible to participate.

All residents must either be covered by a private plan or a public drug plan. The coverage provided under a private plan cannot be less than the minimums set by the public plan. The following individuals are eligible for the Public Prescription Drug Insurance Plan (the “public plan”):

• Persons age 65 and over
• Employment assistance recipients and other holders of a claim slip
• Persons who do not have access to a private plan
• Children of persons covered by the public plan

Saskatchewan Drug Program Plan provides benefits to eligible Saskatchewan residents for certain drugs prescribed outside Saskatchewan hospitals.
Special support is available when drug costs exceed 3.4% of family income Residents qualifying for the GIS and Saskatchewan Income Plan (SIP) in Saskatchewan also receive the following benefits:

GIS recipients:

• If living in the community, the semi-annual deductible is $200 for prescription drugs with a 35 per cent co-payment thereafter
• If residing in a special care home, the semi-annual deductible is $100 for prescription drugs with a 35 per cent co-payment thereafter
• Residents may be eligible for additional drug coverage through the Special Support Program

SIP recipients:

• $100 semi-annual deductible for prescription drugs; 35 per cent consumer co-payment thereafter.

Seniors' Drug Plan
Effective July 1, 2007

• Available to all Saskatchewan residents age 65 and over
• Seniors pay no more than $15 per prescription for drugs listed in the Saskatchewan Formulary, including approved drugs under Exception Drug Status

Pharmacare eligibility:

• Must be registered with the Yukon Health Care Insurance Plan (YHCIP)
• Must be a Yukon resident at least 65 years of age or aged 60 and married to a living Yukon resident who is at least 65 years of age

Pharmacare pays total costs of lowest priced generics of all prescription drugs listed in the Yukon Pharmacare Formulary, including the dispensing fee. Certain non-prescription drugs and goods are also covered by the program such as:

• Compounds used in the control of heart disease; nitroglycerin, preparations, digoxin and other digitalis related products; anti-inflammatory drugs, analgesics, used for the symptomatic relief of arthritic conditions insulin syringes

Children's Drug Program - Provides assistance to low income families for prescription drugs for children.