Insurance and Government Support

Alberta Health offers a number of health benefit plans administered by Alberta Blue Cross and financial assistance programs.

Non-Group Coverage Benefit

Non-group coverage provides all Albertans with access to supplementary health benefits programs. These programs provide coverage for a variety of health-related services not covered by the Alberta Health Care Insurance Plan (AHCIP) to all Alberta residents under 65 years of age and their dependents, as registered under the AHCIP.
 
A deductible ($50/annually) applies to the total of all health benefit expenses incurred in a year, except for prescription drugs. The co-payment is 30% to a maximum of $25.
 
Some high-cost drugs (e.g., biologics) require special authorization according to defined clinical criteria. Physicians must complete a special authorization request form, and clinical pharmacists must review the completed form. Prior approval is required for coverage by special authorization.

Click here for information about eligibility and the application process.
 
Click here for a full list of drugs covered under Alberta Supplementary Health Benefit Plans.

Alberta Seniors Health Care Coverage

This program offers seniors, their spouses/interdependent partners and dependents registered on the same account (if applicable), with a premium-free benefit to provide coverage for prescriptions and other health-related services not covered by Alberta Health Care Insurance Plan (AHCIP).
 
Click here for information on eligibility and the application process.

Alberta Adult Health Benefit

This program provides coverage for Albertans in low-income households who have high ongoing prescription drug needs. Coverage includes high ongoing prescription drugs, ambulance services, and essential over-the-counter medication.
 
Click here for more information on eligibility and the application process.
 
Click here to search for drugs covered under this benefit. Special authorization may be required for some drugs, supplements, and vitamins.

Alberta Child Health Benefit

This program provides health and drug coverage to children of low-income families. Coverage includes prescription drugs as well as some supplements and vitamins.
 
Click here for more information on eligibility and the application process.

Alberta Aids to Daily Living (AADL)

This program provides funding for basic medical equipment and supplies to meet clinically assessed needs of individuals with long-term disability, chronic illness or terminal illness, in maintaining independence in their community. Albertans pay 25% of the benefit cost to a maximum of $500 per individual or family per year. Low-income Albertans and people receiving income assistance are exempt from paying the cost-sharing portion. This program assists with coverage for ostomy supplies for residents who have a permanent colostomy, ileostomy, or urostomy. Currently, the program does not cover temporary ostomies.
 
Click here for information about ostomy supply coverage in Alberta.
 
Click here for information on eligibility and the application process.

Assured Income for the Severely Handicapped (AISH)

This program provides financial assistance to individuals over 18 years of age, and their dependents, who have a medical condition that is likely to remain permanent and substantially limits ones’ ability to earn a living. You may receive a monthly living allowance for food, rent, and/or utilities; a monthly child benefit; health benefits for yourself, your spouse or partner, and dependent children; personal benefits and/or money provided over the monthly living allowance for specific needs, such as a special diet or assistance in an emergency.
 
Click here for more information on eligibility and the application process.

Medical Services Plan of B.C (MSP)

This provincial insurance program provides full coverage for required medical services provided by physicians, dental and oral surgery, other supplementary healthcare services, and some diagnostic services.
 
Click here for more information about eligibility and the application process.

Click here for a list of services not covered under MSP. Please note the program does not provide prescription drug coverage as the BC PharmaCare Plans provides this type of coverage.

Click here for a full list of prescription drug coverage plans offered to residents of BC who are active in MSP.

Fair PharmaCare Plan & Families and Fair PharmaCare

British Columbians with Medical Services Plan (MSP) coverage can register for Fair PharmaCare, the largest BC PharmaCare plan. Available to individuals or families, PharmaCare provides coverage for prescription drugs, and certain medical supplies and pharmacy services. Family net income determines the amount of coverage the plan provides.

The program covers Ostomy supplies. Click here for more information

Click here for more information about eligibility and the application process.

Click here to search for drugs covered under the Fair PharmaCare program.

Considered limited coverage, biologics require special authority. For more information on how to apply, visit the Government of British Columbia’s website.

Disability Assistance

This program provides financial or health support to persons designated as a ‘Person with Disabilities (PWD)’. To be eligible, an individual must be 18 years of age or older; have a severe physical or mental impairment expected to continue for more than two years; be significantly restricted in the ability to perform activities of daily living; require assistance with daily living activities; and meet financial eligibility to receive assistance.

The amount of assistance or financial support provided will depend on the size of family, and if other family members have a PWD designation.

An individual on disability assistance can still work and earn money up to a certain amount without affecting monthly assistance payments. Click here to see how much income you can receive with no deductions to assistance payments.

Eligible applicants may also receive general and health supplements to assist with the extra costs people with disabilities may incur. Click here to learn about the general supplements you could acquire through income assistance.

PWD who have a severe medical condition causing a chronic, progressive deteriorating of health with symptoms of wasting may also receive monthly nutritional supplements. The supplement provides essential needs to maintain regular nutritional needs. Click here to find out more about this supplement.

Click here for more information on eligibility and the application process.

Click here to get an estimate on eligibility before applying for assistance.

Get in contact with a support worker to request a ‘Persons with Disabilities Designation-Prescribed Class’ application to determine PWD eligibility.

Income Assistance

This program assists individuals out of work or not earning enough to meet basic needs; waiting for other sources of money to arrive; cannot work at all; and are urgently in need of food, shelter, or medical attention. This program is a ‘last resort’ as you must look for and use all other sources of income or assets before applying. Eligible applicants may also receive general and health supplements to assist with the extra costs.

Click here to learn about the supplements you may acquire through income assistance.

Click here for more information on eligibility and the application process.

Seniors Supplement

This program provides income support to residents of British Columbia who are 65 years of age or older, and currently receive Old Age Security (OAS) and Guaranteed Income Supplement (GIS) allowances. Annual income reported from the previous year determines the amount of assistance provided by OAS and GIS. The support provided through OAS and GIS determines the amount provided through the Seniors Supplement program. Eligible applicants automatically receive the supplement one month after the first OAS/GIS payment. 

Click here for more information and supplement payment estimates.

Manitoba Pharmacare Program

This program provides coverage for high-cost prescription drugs for individuals of ages who are not receiving coverage for their prescription drugs by other provincial or federal drug benefit programs. Coverage is determined by total family income and the amount you pay for eligible prescription drugs, and is adjusted to include a spouse or partner and the number of dependents. You must pay an annual deductible an that is based on adjusted family income. Click here to get an estimate for the Pharmacare deductible rate.

Click here for more information about eligibility and the application process.

Click here to search the drug formulary to see if your prescription drug is eligible. Some prescription drugs (e.g., biologics) may require a drug exemption status. 

The Manitoba Ostomy Program (MOP)

This program provides full coverage for the cost of ostomy supplies to eligible individuals who are residents of Manitoba; registered with Manitoba Health Services Commission; and have lost the normal function of the digestive or urinary system requiring ostomy or fistula management; or have drainage from the lymphatic system in a quantity that requires the use of ostomy appliance.

You register with MOP through your E.T nurse after surgery. After registration, you can order supplies, which you will receive by mail or courier, through the Health Sciences Center Materials Handling (1-877-477-4773).

Click here for more information about eligibility and the application process.

Employment and Income Assistance for Persons with Disabilities

This program provides income support to qualified individuals and their dependents. You may also qualify for health and drug coverage benefits. You may receive health coverage for medical supplies, prescription food supplements, prescription drugs, special diet allowance, and transportation for medical appointments.

To be eligible for the program, you must be a resident of Manitoba; 18 years of age or older; have a mental or physical disability that is likely to last more than 90 days and this disability does not allow you to earn enough money to pay for their or their family’s basic needs; you are in financial need (i.e., total cost of their family's monthly basic needs and shelter costs are greater than their total financial resources); and based on income and assets, size of family or household, and the cost of ongoing medical needs.  

Click here for more information on eligibility and the application process.

New Brunswick Drug Plans

This program provides prescription drug coverage to individuals without drug insurance. All members who are 18 years of age or older must pay a monthly premium and a minimum copayment of 30%. Annual household or family income determines premiums and copayments. The plan covers the drugs listed in the NB Drug Formulary, and most are reimbursed with no criteria or prior approval requirements. 

Click here for more information on eligibility, application process, and eligible prescription drugs.

Some prescriptions may require Special Authorization approval prior to reimbursement. Click here for more information.

The exclusion list in the Formulary identifies drug products that are not eligible. These products include over-the-counter non-prescription drugs, vitamins, and minerals; and/or medical supplies including ostomy supplies. Under exceptional circumstances, drugs ineligible through the Formulary and Special Authorization may receive approval for coverage on a case-by-case basis.

New Brunswick Drug Plans for Seniors

This program provides coverage to individuals who are 65 years of age and older who do not have prescription drug coverage from another plan, and receive the Federal Guaranteed Income Supplement (GIS) from Employment and Social Development Canada. Older persons who do not receive GIS may be eligible for the program if their income falls below a certain amount. Older persons can also enroll in the New Brunswick Drug Plan (see above).

Click here for more information on eligibility and the application process.

Health Services Ostomy/Incontinence Program

This program provides coverage for ostomy, cauterization and incontinence supplies not covered by other agencies or private health insurance. Eligible supplies include those directly related to the management of a colostomy, ileostomy or urostomy; internal, external or intermittent cauterization; and/or incontinence. Examples of items not covered by this program include wipes, anti-diarrheal products, bowel prep products, stool softeners, pouch covers, and sterile gloves. Eligible services are paid on a monthly basis.

Click here for more information on eligibility and the application process.

Disability Support Program

This program provides support to individuals with disabilities who are 19 to 64 years of age; have a long-term disability (this does not include a medical condition that does not result in long-term disability); and require disability-related supports to address unmet needs and establish living arrangements. Supports may include home support workers; personal living skills training; transportation; and/or residential facility services.

Supports do not include income support; medical services or prescription drugs; mental health and addiction services; and/or childcare services. A financial assessment will take place to determine the programs contribution towards the cost of approved disability supports.

Click here for more information on eligibility and the application process.

Social Assistance

This program assists individuals who have no other income (‘last resort’) to meet their basic needs of food, clothing, and shelter. An assessment of all sources of income for each household determines eligibility for the program and the amount of assistance provided. All social assistance clients receive a health card that provides coverage for medical services, prescription drugs, and other health needs.

Click here for more information on eligibility and the application process.

Prescription Drug Program (NLPDP)

This program provides coverage for prescription medication, medical supplies, and pharmacy services. Residents may be eligible for partial or full coverage if they qualify for one of NLPDP’s drug programs.

Click here for information about this program and the application process. 

Click here to search the formulary for eligible prescription drugs and medical supplies.
 
Some prescriptions may require special authorization. Consideration for special authorization requires the prescribing physician to submit a Special Authorization Request form. Click here for more information on accessing prescriptions through special authorization.

The Foundation Plan

This program provides full coverage for prescription drugs to persons or families receiving income support benefits through the Department of Advanced Education and Skills, and to children receiving care through Child, Youth and Family services. There is no application process to enroll in this program. Persons and families automatically qualify for the program once the Department of Health and Community Services receives notification of their participation in one of the income support benefit programs listed above.

Click here for more information about this program.

The 65Plus Plan

This program provides coverage to individuals who are 65 years of age or older who receive Old Age Security (OAS) Benefits and the Guaranteed Income Supplement (GIS) through the federal government. You must pay a pharmacy-dispensing fee of up to a maximum of $6.00. If you qualify for this program, you are eligible for the Ostomy Subsidy Program, which provides a reimbursement of 75% of the cost of ostomy supplies.

There is no application process to enroll in the 65Plus Plan as you automatically qualify once the Department of Health and Community Services receives notification of your participation in the GIS and OAS.

Click here for more information about this program.

The Access Plan

This program provides coverage to low-income individuals and their families for prescription medication. Household income and the number of children or dependents determines the amount of assistance you receive.

Click here for more information on eligibility and the application process.

The Assurance Plan

This program provides coverage to individuals and families for prescription medication. Income level and drug costs determine eligibility and co-payment costs. Every six months, program eligibility and co-payments assessed.

Click here for information on eligibility and the application process.

Special Assistance Program (Disability Services): Medical Equipment and Supplies

This program provides basic medical supplies and equipment to help individuals living within the community with their daily living. Medical supplies include dressings, catheters, and incontinent supplies. Equipment may include walking aids, orthotics, and oxygen supplies.

Click here for more information about this program.

Please contact your regional health authority for eligibility and instructions on how to apply. 

Income Support and Associated Health Benefits

This program provides financial assistance to individuals who are 18 years of age or older and their families to help with daily living expenses and basic needs such as food, clothing, personal care, and shelter. In some cases, you will receive support for non-basic needs, such as eye examinations and medical transportation. You and your family may also receive benefits from the Newfoundland and Labrador Prescription Drug Program and the Special Assistance for Medical Supplies and Equipment program.

The amount of support received is based on family income and other family resources; the number of adults and children in family; current living arrangements; types of benefits required to meet basic and special needs; and employment related expenses such as transportation and childcare.

Click here for monthly basic income estimates. If you and your family net income is less than your basic living requires, you may still be eligible for income support even if you are working.

Click here for information about this program including eligibility and the application process.

Department of Community Services Pharmacare Benefits

This program provides coverage for prescription drugs and medical supplies to individuals in the following programs: Income Assistance clients (includes Extended Pharmacare and Transitional Pharmacare clients); Disability Support Program clients; children in the care of child welfare; and Low income Pharmacare for children clients.

Click here for more information on eligibility and the application process.

Some prescriptions may require Exception Status Coverage (ESD). Coverage for ESD will be determined according to criteria upon review of a prescriber’s written request. Click here for ESD criteria and a list of eligible drugs.

Family Pharmacare Program

This program provides coverage for prescription drugs and medical devices or supplies to families who have no drug coverage or if the cost of the prescription drugs is deemed to be a financial burden. To remain eligible, the Canada Revenue Agency will verify your family’s income every year.

Persons are not eligible if they receive coverage from any of the following programs: Nova Scotia Seniors’ Pharmacare Program; Nova Scotia Diabetes Assistance Program; under 65-Long Term Care Pharmacare Plan; and/or any Nova Scotia Department of Community Services Pharmacare Benefits. There is no premium or fee to join this program. Annual family copayment and deductible maximums are determined based on family size and annual income.

Click here for more information on eligibility and the application process.

Click here to calculate your maximum annual family deductible and annual family copayment.

Seniors’ Pharmacare Program

This program provides coverage for prescription drugs and medical supplies to individuals who are 65 year of age or older that do not have prescription drug coverage under another plan or program. You will pay an annual premium and copayment based on household income. Some members may be eligible for a reduced or waived premium.

Click here for more information on eligibility and the application process.

Click here to calculate your maximum annual premium.

Disability Support Program (DSP)

This program assists children, youth, and adults living with disabilities. To be eligible for the program, the applicant must be 19 years of age or older; have an intellectual disability, long-term mental illness, and/or physical disability.

A physical disability is a long-term, chronic and persistent physical limitation that creates difficulties in functioning in two or more aspects of activities of daily living or instrumental activities of daily living. Physical disability limits functional independence and person requires ongoing support.

Flex Individualized Funding provides self-directed/managed funding to individuals living at home with their families or individuals who live independently with support from their families or social networks.

Direct Family Support for Children provides funding to help support caregivers of children with disabilities living at home.

Click here for more information on the support services offered by the DSP program, eligibility criteria, and the application process.

Income Assistance

This program provides individuals who are 19 year of age or older in financial need with assistance with basic needs (e.g., food, rent, utilities), transportation, emergency dental care, special diets, and prescription drugs. An individual meets the financial criteria if their monthly income is less than the amount required for basic needs, as defined by the program.

Members of this program are eligible to receive drug coverage through the provinces’ Pharmacare programs listed above.

Click here for more information about the program.

The Nunavut Department of Health offers a number of health insurance programs that provide either partial or full coverage for medical treatments, prescription drugs, medical supplies, and medical travel. Please see below for information about the available programs.

Extended Health Benefits

This program provides coverage for prescription drugs and medical supplies not covered by the Nunavut Health Care Plan. The Extended Health Benefits program applies to all residents who are not covered or fully covered by their third-party insurance (e.g., Health Canada’s Non-Insured Health Benefits Program) or employer-provided health plans; non-indigenous residents with one of specified conditions (including Crohn’s disease or ulcerative colitis); and non-indigenous residents who are 65 years of age or older. 

Click here for information about this program and the application process. 

Click here to search the formulary for eligible prescription drugs and medical supplies under your specified condition.

Non-Insured Health Benefits

This program provides coverage for prescription drugs, some over-the-counter products, medical supplies and equipment, dental services, and medical travel to residents of Canada recognized by one of the Inuit Land Claim Organizations, a registered Indian according to the Indian Act or an infant less than one year of age, whose parent is an eligible recipient. You should use your third party or work insurance prior to applying for reimbursement from Non-Insured Health Benefits.

Click here for information on eligibility and the application process.

Click here to search the formulary for eligible prescription drugs and medical supplies.

The Nunavut Health Care Plan-Medical Travel

This program provides support to individuals who, as instructed by a healthcare professional, must travel outside their own community to receive medical services. To qualify for this benefit your healthcare professional must approve medical treatment outside of their home community prior to travel; the medical treatment must be urgent; and you must have exhausted third party and employer insurance options or have no insurance plan. 

If you qualify for the Extended Health Benefits program you will receive travel benefits to cover costs not covered by the Nunavut Health Care Plan.

Click here for information about eligibility and the application process. 

Income Assistance

This program is intended as a last resort to support individuals 18 years of age or older and their families with the cost of basic needs for reasons such as disability, illness, and low-income or periods of unemployment. Recipients of this program must undergo a monthly financial assessment with an Income Assistance Worker.
 
Click here to begin the application process by contacting an Income Assistance Worker.  

Click here for more information on eligibility and the application process.

Senior Citizen Supplementary Benefit (SCSB)

This program provides a monthly payment of $175.00 to low-income residents of Nunavut who are 60 years of age or older and are receiving the Guaranteed Income Supplement (GIS) or the Spouse’s Allowance from the federal government.

Click here for information on eligibility and the application process.

Ontario Drug Benefit Program

This program provides coverage for eligible prescription drugs, some prescribed over-the-counter drugs, and nutrition products. To qualify, you must be an Ontario resident who is 65 years of age or older. Individuals automatically join the program on the first day of the month after turning 65 years old. 

Individuals may be eligble before 65 years of age if they are: living in a long-term care home, home for special care or community home care; 24 years of age or younger and not covered by a private insurance plan; receiving professional home and community care services; or be enrolled in Ontario Works, Ontario Disability Support Program, or the Trillium Drug Program (see below).

Click here for more information on eligibility and the application process.

Click here to search the formulary for eligible prescription drugs.

Some prescriptions may require approval through the Exception Access Program (EAP). Click here for more information on how to apply to EAP.

Trillium Drug Program

This program provides coverage for prescription drugs to individuals who spend approximately 4% or more of their after-tax household income on their prescribed drugs. In order to be eligible for this program you must NOT already qualify for the Ontario Drug Benefit and do not have an insurance plan that pays for 100% of prescription drugs. 

The Trillium Drug Program covers the same drugs as the Ontario Drug Benefit and the EAP.

Click here for more information on eligibility and the application process.

Some prescriptions may require approval through the EAP. Click here for more information on how to apply to EAP.

OHIP +: Children and Youth PharmaCare

This program provides full coverage for prescription drugs to residents of Ontario who are 24 years of age or younger that have a valid OHIP card and are not covered by a private insurance plan.  Please note, you do not need to enroll or register to access OHIP + (coverage is automatic if you’re not covered by a private plan). OHIP+ covers the same drugs as the Ontario Drug Benefit and the Exceptional Access Program (EAP).

Click here for more information about the program.

Click here to search the formulary for eligible prescription drugs.

Some prescriptions may require approval through the EAP. Click here for more information on how to apply to EAP.

Assisted Devices Program (Enteral Feeding and Ostomy)

This program covers the cost of medical supplies for individuals who have had a colostomy, ileostomy, fecal continent reservoir, urostomy, ileal conduit, or urinary continent reservoir. The ostomy must be permanent, or temporary if required for at least 6 months. To qualify for the program, you must submit an Application for Funding Ostomy Grant form that is certified by a doctor or nurse practitioner.

The program also provides coverage for enteral-feeding pump and supplies. To qualify for enteral-feeding coverage you must have a physical disability requiring enteral feeding to maintain nutrition; require feed pump-feedings for six hours or more per day; and not be a resident of a long-term care home.

Click here for more information on eligibility and the application process.

Ontario Disability Support Program (ODSP)

This program provides financial assistance to you and your family to help with essential living expenses and benefits, including prescription drugs. To qualify, you must be 18 years of age or older, meet the program’s definition of a person with a disability, and be in financial need.

An individual is in financial need if the costs of their household’s basic living expenses are more than their household income and assets. A caseworker will determine eligibility for financial need, and will give a Disability Determination Package for the applicant to fill out with their healthcare provider(s).

Click here for more information on eligibility and the application process.

Assistance for Children with Severe Disabilities

This program provides financial aid to parents for costs related to their child’s severe disability. The funding program helps low- and moderate-income families with the cost of prescription drugs as well as the cost of travel to healthcare provider appointments, hospitals and other appointments related to the child’s disability. The amount of aid received depends on family or household income, size of family, severity of disability, and extraordinary costs related to disability.

Click here for more information on eligibility and the application process.

PEI Pharmacare

This program provides coverage for prescription medication, medical supplies, and pharmacy services. PEI residents may be eligible for partial or full coverage if they qualify for one of PEI’s drug cost assistance programs.

Click here for information about the program. 

Click here to search the formulary for eligible prescription drugs and medical supplies.
 
Some prescriptions may require special authorization. Consideration for special authorization requires the prescribing physician to submit a Special Authorization Request form. Click here for more information on accessing prescriptions through special authorization.

High Cost Drug Program

This program provides coverage for high-cost medications for individuals diagnosed with one or more of the following conditions: moderate to severe or fistulizing Crohn’s disease; advanced colorectal cancer, rheumatoid and psoriatic arthritis; plaque psoriasis; relapsing-remitting or progressive multiple sclerosis; and ankylosing spondylitis. Household income determines eligibility for the program and the amount of available coverage.
 
You must complete the High Cost Drug Program Application form, and have their prescribing physician or diagnosing specialist submit a Special Authorization Request form as well as other relevant medical information on their behalf.

Click here for more information on eligibility and the application process.

Generic Drug Program

This program provides coverage to individuals 64 years of age or younger who do not have private or work drug insurance coverage. Out-of-pocket costs for eligible generic prescription drugs are limited to a maximum cost of $19.95. This program does not provide coverage for diabetes drugs, narcotics, or controlled/targeted substances.

Click here to search the formulary for eligible prescription drugs.

Click here for more information on eligibility and the application process.

Seniors Drug Program

This program provides coverage for the cost of medications to individuals who are 65 years of age or older. Eligible residents will automatically enroll in the program once they are 65 years old. The co-payment for each prescription is $8.75, plus the pharmacy professional fee ($7.69).

Click here for information about this program.

Click here to search the formulary for eligible prescription drugs.
 
Some prescriptions may require special authorization. Consideration for special authorization requires the prescribing physician to submit a Special Authorization Request form. Click here for more information on accessing prescriptions through special authorization.

Family Health Benefit Drug Program

This program provides coverage to low-income families for prescription medications for the individual and their children who are under 19 years of age or under 25 years of age if the child is a full-time student. Coverage is determined based on family size and household income. The program covers the full cost of the medication, but you must pay a pharmacy-dispensing fee. 

Click here for information on eligibility and the application process.

Click here to search the formulary for eligible prescription drugs and medical supplies.
 
Some prescriptions may require special authorization. Consideration for special authorization requires the prescribing physician to submit a Special Authorization Request form. Click here for more information on accessing prescriptions through special authorization.

Financial Assistance Drug Program

This program provides full coverage for prescription and non-prescription medications to individuals eligible for financial assistance under the Social Assistance Act and Regulations.

Click here for information on eligibility and the application process.

Click here to search the formulary for eligible prescription drugs and medical supplies.
 
Some prescriptions may require special authorization. Consideration for special authorization requires the prescribing physician to submit a Special Authorization Request form. Click here for more information on accessing prescriptions through special authorization.

AccessAbility Supports

This program provides support to individuals with physical, intellectual, neurological, sensory, and/or mental disabilities. Types of support include personal daily living assistance (e.g., meal preparation and grocery shopping, technical, or assistance aids); housing support or independent living (e.g., financial assistance for caregiver, financial assistance required for home modifications); community supports (e.g., employment services and skills training, transitioning from education to workforce, personal aid, or specialized transportation); caregiver or family member supports; and financial support or ‘assured income’ (e.g., basic living expenses such as food, clothing, shelter, household, and personal supplies).

Click here for more information about this program.

Social Assistance

This program assists low-income individuals to meet basic needs such as food, shelter, medications, and basic dental services. The amount of assistance provided depends on household income, number of children or dependents, and home ownership status.

Click here for more information about this program.

Public Prescription Drug Insurance Plan

This program provides coverage for prescription drugs to individuals who are 65 years of age or older; recipients of last-resort financial assistance; or who are not eligible for private plan benefits. A person receiving last-resort financial assistance benefits automatically registers for the Public Prescription Drug Insurance Plan when their file is created.

Children of persons covered by the public plan can also receive coverage if they are 18 years of age or younger; or 18 to 25 years of age who are spouseless and full-time students at the secondary, college, or university level.

Click here for more information on eligibility and the application process.

Click here for a list of drugs covered in this program, including exceptional drugs.

Ostomy Appliances Program (OAP)

This program provides coverage for the cost of ostomy supplies for individuals insured under the Québec Health Insurance Plan who have undergone a permanent colostomy, ileostomy, or urostomy. Some private plans may cover the difference between the total cost of the ostomy supplies and the amount paid out by the OAP program.

Click here for more information on eligibility and the application process.

Social Assistance and Social Solidarity Programs (Last-Resort Financial Assistance)

This program provides financial assistance to individuals who are 18 years of age or older who have a severely limited capacity for employment due to a serious medical condition that impairs a person's physical or mental condition either permanently or for an indefinite period; and whose education and work experience limits their capacity for employment.

Click here for information eligibility and the application process.

The Saskatchewan Drug Plan

Saskatchewan residents with valid Saskatchewan health coverage may be eligible for the Saskatchewan Drug Plan. Costs of prescriptions vary depending on the type of benefits you receive. A pharmacist will submit an online prescription claim form to the Drug Plan ‘claims system’ to seek approval for coverage.

Residents whose health services are covered under existing federal programs such as through First Nations and Inuit Health, Health Canada, Department of Veteran Affairs, Worker's Compensation, and federal penitentiaries are not eligible for these  benefits.
 
Click here for information about Saskatchewan Drug Plans.
 
Click here to search for drugs covered by eligible drug plans. Ask a physician or pharmacist if the prescribed drug is included in the Formulary.

Special Support Program (High Cost Drug Assistance)

This program assists with coverage for high drug cost. Financial assistance is determined based on the applicant’s household income. Drug costs are evenly distributed over the course of the year. Anyone with a valid Saskatchewan health card is eligible for the program.

Individuals whose drug costs may exceed 3.4% of household income should apply. The co-payment is determined by the amount the family drug costs exceed 3.4% of the adjusted combined family income.

To apply for this program, visit any pharmacy or contact the Drug Plan and Extended Benefits Branch in Regina at (306) 787-3317 or toll-free at 1-800-667-7581.

Click here for more information.

Children’s Drug Plan

Families pay a maximum of $25 per prescription for drugs listed on the Saskatchewan Formulary and those approved under the Exception Drug Status. Ask your physician or pharmacist if medications qualify for Exception Drug Status. If you already pay less than $25 per prescription for your child, you will continue to do so. Over-the-counter herbal products and medications not listed in the Saskatchewan Formulary are not included in this drug plan.

Click here for more information about eligibility and the application process.

Click here to search for drugs in the Saskatchewan Formulary.

Click here for drugs approved under the Exception Drug Status.

Seniors’ Drug Plan

Individuals who are 65 years of age or older pay a maximum of $25 per prescription for drugs listed in formulary and those approved under the Exception Drug Status. To apply for this program you must be eligible for the provincial age credit, a credit based on the annual net income reported on Line 236 of an income tax form in the previous year. You are not eligible for the Seniors’ Drug Plan if you are covered under federal government programs, such as Non-Insured Health Benefits Program or Veterans Affairs.

Click here for more information on eligibility and the application process.

Click here to search for drugs in the Saskatchewan Formulary.

Click here for drugs approved under the Exception Drug Status.

Family Health Benefits

This program offers health benefits to low-income families who are currently working and qualify based on an income test or are receiving the Saskatchewan Employment Supplement.
Coverage for children includes dental services, eye examinations, ambulatory services, basic medical supplies (some items require prior approval), and prescription drugs in the Saskatchewan Formulary. 

Coverage for parents or legal guardians include eye examinations and drug coverage with $100 semi-annual family deductible and 35% consumer co-payment.

Click here for more information on eligibility and the application process.

Click here to search for drugs in the Saskatchewan Formulary.

Emergency Assistance for Prescription Drugs

This program provides one-time emergency assistance coverage for prescription drugs required immediately for individuals who are unable to cover their share of the cost.

Click here for more information on eligibility and the application process.

Saskatchewan Aids to Independent Living (SAIL)

This program provides people living with physical disabilities and/or certain chronic health conditions with coverage for disability-related equipment, devices, products, and supplies. This can include coverage for therapeutic nutritional products and children’s enteral feeding pumps.

In order to receive coverage for therapeutic nutritional products, you must receive a referral to the program by a dietician; require the nutritional product for at least four consecutive months; and experience malabsorption, maldigestion, failure to thrive and/or swallowing difficulties. Coverage for enteral feeding pumps requires referral to the Children’s Enteral Feeding Pump Program by a dietician and a specialist physician.

The Special Benefit Program through SAIL provides coverage for ostomy supplies (50% of the cost of supplies). To receive coverage you must have some type of urinary or bowel diversion (colostomy, ileostomy, urostomy, utereterostomy, cecostomy, nephrostomy, or fistula) and receive a referral by an Enterostomal Therapy (ET) nurse in Saskatchewan.

Click here for information on eligibility and the application process.

Supplementary Health Benefits

This program provides coverage for non-insured health services to individuals residing in government wards; at provincial correctional institutions; at special care facilities and are eligible for the Senior’s Income Pan; and for individuals who are enrolled in other income support programs (Assured Income for Disability, Assistance Program, Transitional Employment Allowance, and Provincial Training Allowance).

The program provides coverage for incontinence aids (except diapers), ostomy supplies, and prescription drug coverage.

Click here for more information about eligibility and the application process.

Saskatchewan Assured Income for Disability (SAID)

This program provides income support to individuals in financial need who are 18 years of age or older, and have a permanent disability that impairs functioning in activities necessary for daily living. Support is provided for basic needs and living costs (e.g., food, rent, transportation); costs directly related to the disability; and exceptional needs, such as medical services, dietary items, and home care.

Click here for more information on eligibility and the application process.

Seniors Income Plan (SIP)

This program provides a monthly income supplement to individuals who are 65 years of age or older that have little to no income and receive partial or full Old Age Security (OAS) pension and Guaranteed Income Supplement (GIS). Members of this program are eligible for a number of health benefits, such as a reduced semi-annual deductible under the Drug Plan and Extended Benefits program listed above, a subsidy for home care services, and loans for low-cost medical devices.

Click here for more information on eligibility and the application process.

Income Supplements

Individuals who qualify for federal GIS and the SIP in Saskatchewan also receive health benefits.
Click here for more information on eligibility and the application process.

Pharmacare

This program provides coverage for generic prescription drugs and some non-prescription drugs, such as compounds and anti-inflammatory drugs, to individuals 65 years of age or older or individuals aged 60 and married to a Yukon resident who is at least 65 years of age. The program does not provide coverage for medical supplies or equipment, vitamins, anti-diarrheal medication, or laxatives.

You must be register with the Yukon Health Care Insurance Plan to qualify for Pharmacare. Enrollment in Pharmacare is automatic once you turn 65 years old. If you receive benefits through an employer or third party insurance plan, you must first submit claims through that provider and use Pharmacare as a last resort.

Click here for more information about this program.

Click here to search the drug formulary for eligible prescription drugs.

Some prescriptions may require special authorization. Consideration for special authorization requires the prescribing physician to submit an Exception Drug Status form. Click here for more information on accessing exception status drugs.

Extended Health Care Benefits to Seniors

This program provides partial or full coverage for medical supplies and equipment, hearing aids, dental care, eye examinations and glasses to individuals who are 65 years of age or older, or aged 60 and married to Yukon resident who is at least 65 years of age. To qualify you must be registered with the Yukon Health Care Insurance Plan.

Enrollment in the Extended Health Care Benefits is automatic once you turn 65 years old. If you receives benefits through an employer or third party insurance plan, they must first submit claims through that provider and use Pharmacare as a last resort.

Click here for more information about this program.

Children’s Drug and Optical Program

This program provides coverage to children 19 years of age or younger in low-income families for prescription drugs, eyes examinations and glasses, and some medical supplies if directed by a physician or nurse. Families may need to pay a deductible to a maximum of $250 per child and $500 per family. The deductible is determined based on household income. If an you receive benefits through an employer or third party insurance plan, you must first submit claims through that provider and use this program as a last resort. The prescribing physician or community health nurse must apply for this program on your behalf.

Click here for more information on eligibility and the application process.

Click here to search the drug formulary for eligible prescription drugs.

Some prescriptions may require special authorization. Consideration for special authorization requires the prescribing physician to submit an Exception Drug Status form. Click here for more information on accessing exception status drugs.

Medical Treatment Travel

This program provides coverage for the cost of transportation from the individual’s home community to the centre or hospital that will provide services for medical emergencies and non-emergencies. To qualify for coverage medical travel must originate in the Yukon and you must be registered with the Yukon Health Care Insurance Plan. The Medical Treatment Travel program provides a subsidy if you are not admitted to a facility but requires outpatient services.

Click here for more information on eligibility and the application process.

Chronic Disease and Disability Benefits Program

This program provides financial assistance to individuals with a chronic disease (e.g., Crohn’s disease or ulcerative colitis) and disability defined as a serious functional or intellectual impairment. Support is provided for prescription drugs, medical supplies and equipment (e.g., ostomy supplies, syringes, and bandages), and food supplements. You must pay an annual deductible to qualify for this program.

If you receive benefits through an employer or third party insurance plan, you must first submit claims through that provider and use this program as a last resort. The prescribing physician or community health nurse must apply for this program on behalf of the patient.

Click here for more information on eligibility and the application process.

Some prescriptions may require special authorization. Consideration for special authorization requires your prescribing physician to submit an Exception Drug Status form. Click here for more information on accessing exception status drugs.

Yukon Seniors Income Supplement (YSIS)

This program provides income support to individuals who are 65 years of age or older that receive Old Age Security (OAS) and the Guaranteed Income Supplement (GIS). Annual income reported in the previous year determines OAS and GIS. The amount of assistance you receive through OAS and GIS determines the amount provided by YSIS. You will automatically enroll in YSIS once the Yukon Government receives confirmation of your OAS and GIS eligibility.

Click here for more information and supplement payment estimates.

Social Assistance

This program provides financial assistance to individuals who are 19 years of age or older whose income does not meet basic living costs and are not attending post-secondary school. Social assistance as a last-resort option to all other potential source. Individuals with a spouse or partner who has an income that meets basic needs for both individuals are ineligible for the program.

Click here for more information about eligibility and the application process.

Yukon Supplementary Allowance (YSA)

This program provides additional income support to individuals who are currently receiving, or are eligible for Social Assistance, that are 19 years of age or older and unemployable due to severe prolonged disability. Individuals who receive Old Age Security (OAS) may also qualify.

Successful applicants will receive $250.00 per month. Employment income up to $3,900.00 per year will not be included in the calculation of income.

Click here for more information about this program.

Family Supports for Children with Disabilities

This program provides support to families with children who are 19 years of age or younger and have a disability. To be eligible, the child should have a medical or mental health assessment from a doctor, Child Development Centre report, Department of Education report, etc. A formal diagnosis is not required to receive support.

Funding supports counselling, specialized medical research interventions, specialized recreational therapies or camps, and in-home childcare. You do not need to provide financial information to access services, but prior to accessing the program other resources should be used (e.g., private insurance, employee benefit programs, and other government programs).

Click here for more information about available services, eligibility requirements, and the application process.