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What is Pharmacare and How Can it Benefit You?

Benefits, Health

Studies suggest that 1 in 10 Canadians are unable to fill their prescriptions. This finding indicates that even though several options are available to meet medication requirements, most do not include enough provision related to prescription drugs in Canada. Therefore, because these programs were unable to provide universal prescription drug coverage to all Canadians, the idea of Pharmacare came into existence. But what is Pharmacare and the Pharmacare Integration Policy? Keep reading to find out.

What is Pharmacare?

Pharmacare refers to the drug program that every province and territory offers its citizens. Through this program residents can make payments for expensive medical prescriptions and supplies. However, each program comes with its own set of guidelines. At present, Pharmacare programs are running in three locations- British Columbia, Manitoba, and Saskatchewan.

What is Pharmacare Integration Policy?

The government proposed a Pharmacare Integration Policy to ensure that patients access all kinds of pharmacist services. It includes injections, prescription renewals and modifications, safe drug therapy, and so on. Through this policy, the government aims at creating a pan-Canadian framework working on three basic principles. These are:

  • Increase the access of medications to all Canadians.
  • Provide safe and effective drug therapy to achieve better health outcomes.
  • Offer innovative and sustainable prescription drug coverage for patient-centered care.

Who is Eligible?

Most residents receive various benefits if they are a part of a Group Benefits plan. It is an insurance plan that covers a variety of illnesses and health problems that employees may face. While it is a successful approach to provide healthcare and prescription advantages to everyone, it has some drawbacks. This health insurance plan, for example, includes a reasonable limit on the amount of money granted to beneficiaries for treatment. In other words, if the treatment cost exceeds the acceptable limit, the policyholder cannot claim reimbursement for the entire cost.

To address this issue, Pharmacare provides coverage to:

  • Those who are not covered by a Group Benefits plan. Residents who have medical expenses that exceed the amount covered by their Group Benefits plan are also eligible.
  • People with higher-than-average prescription costs in relation to their earnings.
  • Senior persons and children who may be excluded from coverage.

How does it work?

The Pharmacare Integration Policy requires the plan members residing in British Columbia, Saskatchewan, and Manitoba to register for their Pharmacare plans. Once registered, they can receive coverage for all or a part of the eligible costs that the plan sponsors would have otherwise covered. To ensure the system’s smooth operation, a threshold-based claims tracking system is available. The Pharmacare Integration Policy provides plan members with a high level of financial help and reduces out-of-pocket medication expenses. 

Why Pharmacare?

Medical costs should not be a hurdle in obtaining affordable healthcare and medical services. As a result, Pharmacare aims to provide the best medication and pharmacist services possible regardless of a person’s social, geographic, economic, or health status. A comprehensive framework like this can go a long way toward improving people’s health across Canada.

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