Back to blog
Posted by Ed Hofstede, Vice President, Consulting and Client Service, June 14 2023
Health Insurance
Democratizing Medical Care with the Fair Pharmacare Plan

fair pharmacare plan

How the BC Fair Pharmacare plan is helping residents facing financial challenges.

The British Columbia (BC) Fair Pharmacare plan is publicly funded and helps eligible BC residents with the cost of prescription drugs. The program is designed to assist those facing financial challenges in accessing necessary medications.

One aspect of the program that is particularly important for those with more complex medical needs is the Special Authority program. This program allows doctors to request coverage for medications that may not be covered under the standard Pharmacare plan. The Special Authority program is intended to provide coverage for prescription drugs that are not considered to be first-line treatments or for those with specific medical conditions.

For example, if a patient requires a medication not on the standard Pharmacare formulary for their condition, their doctor can apply for Special Authority coverage. The request will be reviewed by a team of medical professionals, who will assess the patient's medical history and determine whether the medication is appropriate for their condition. If approved, the drug will be covered by Pharmacare.

Expanding Access to the Fair Pharmacare Plan in the Workplace 

Integrating the Fair Pharmacare plan with employer-sponsored health and dental plans is also essential for those with more complex medical needs. Many patients have employer-sponsored health insurance plans that provide coverage for prescription medications. 

By integrating the Fair Pharmacare plan with these plans, individuals may continue accessing comprehensive coverage for their prescription drug needs while reducing out-of-pocket expenses. 

Employers can also benefit from this integration by lowering overall healthcare costs while maintaining comprehensive employee coverage. In practice, prescription drugs reimbursed by the employer-sponsored health plan are applied against satisfying an individual’s annual Fair Pharmacare deductible. Pharmacare begins to pay for the prescription once the annual deductible is satisfied. 

Coordination is Key to Coverage Success 

Some challenges are associated with integrating the Fair Pharmacare plan with employer-sponsored health and dental plans. One of the main challenges is ensuring consistency in coverage across different programs. This may require careful coordination between the provincial government, employers, and insurers to ensure that individuals can access the coverage they need, regardless of which program they are enrolled in.

Overall, the Fair Pharmacare and Special Authority programs ensure that all BC residents can access their medications. Integrating these programs with private health and dental plans ensures that patients with complex medical needs can access the medicines they need, regardless of their financial circumstances.

Contact AGA Benefits Solutions for a comprehensive review of your benefits program

I want to get a quote!

Ed Hofstede holds an Honours degree in Business from Wilfrid Laurier University and is an active member of CALU and TPAAC. He is a passionate and active advocate for workplace and youth mental health initiatives. Ed aims to deliver not only best-in-class benefit solutions, but healthy, engaged, loyal, and productive employees for our clients.
Ed Hofstede, Vice President, Consulting and Client Service