Pharmacare & other benefits

Government coverage programs

Below are listings of possible financial coverage for your ostomy supplies.  It can be confusing to figure out the system. We are here to help.

We can bill directly to BC Pharmacare, DVA, WorkSafe BC and ICBC, and the First Nations and Inuit Health Branch (FNIHB) Non-Insured Health Benefits (NIHB).

In BC, ostomy supplies are similar to prescription drugs, which are covered under the provincial government program, Fair Pharmacare. Pharmacare is a program that offers coverage based on family net income, designed to provide fair access to coverage for prescription drugs and certain medical supplies such as ostomy supplies.

Please visit BC Pharmacare for more information.

Most ostomy supplies qualify for coverage under the BC Fair Pharmacare program. Their website includes a list of ostomy supplies that are covered, as well as items that are not. If you have questions, our pharmacy technicians will be happy to help you find an answer.

The deductible calculated by Fair Pharmacare is based on income from two years prior (e.g.: for 2016 they use income from 2014).  If your family income has decreased by more than 10%, you can apply to have Pharmacare recalculate your deductible.  Please visit the link for more information, including the required form, or call Fair Pharmacare.

Pharmacare also provides an option to pay your deductible monthly. To enroll in the Monthly Deductible Payment Option, contact Fair Pharmacare:

604-683-7151 in the Lower Mainland or   1-800-663-7100 in the rest of BC

 

Extended health programs

Extended health plans are programs usually offered through work or your employer.  Some examples are Manulife, Blue Cross, and Green Shield.  When you purchase ostomy supplies, your official receipt shows how much the BC Fair Pharmacare program has paid. You can submit your receipts to your extended health plan on the claim form provided by the individual plan. Extended health care plans do not allow us, or any other pharmacy, to bill them directly for ostomy supplies.

This is Health Canada’s national health benefit program that provides coverage for specific medical supplies, among other things, for eligible First Nations people and Inuit people. For more information about this program, visit the NIHB information page.
Veterans Canada provide financial support to qualified Veterans for health care services and benefits. For more information, visit the DVA benefits page.
People with an ostomy may qualify for the Disability Tax Credit. The Canada Revenue Agency provides forms and guides on applying for this program.  
Talk to you accountant or Canada Revenue Agency (CRA) about what medical expenses are eligible as a medical expense.
CRA: 1-800-959-8281

The BC Cancer Agency offers information on assistance with both medical and non-medical costs such as nutritional supplements and other cancer related community financial assistance programs.

If you receive social assistance you may qualify for an additional amount for protein depending on your diagnosis. Consult your physician or nurse practitioner to see if you qualify. Information on applying and criteria for the protein supplement are found on the Government of BC website. 

Serving or discharged members of the RCMP can find out more information about their benefits from the RCMP benefits page

People receiving benefits from WorkSafe can talk to their case managers or find out more information on the Worksafe website.

People receiving benefits from ICBC should talk to their case manager about coverage and how ostomy supplies figure into their settlement. 

 

Cost-Saving Strategies

We want you to have good wear time. An Enterostomal Therapy (ET) nurse can review your pouching system and application technique to make sure you are getting reliable wear time. The Canadian Association of Enterostomal Therapists (CAET) can help you find an ET nurse.

Eric who writes the Vegan Ostomy blog offers an excellent listing of different options in his article Dealing with Ostomy Supply Costs in Canada