Pharmacare provides drug cost assistance to eligible Manitobans who do not have coverage under a federal or other provincial program. Pharmacare is income based, which means a deductible is calculated based on the total adjusted family income. Once the yearly deductible has been reached through the purchase of eligible prescription drugs at a pharmacy, Pharmacare will pay 100 per cent of eligible prescription costs for the remainder of the benefit year. The Pharmacare benefit year is April 1 to March 31 of the following year. In order to be eligible for benefits, an application must be received in our office on or before March 31 of the current benefit year. For information on how to apply to Pharmacare please visit "Applying for Pharmacare".
An eligible drug is one that is covered by Pharmacare. Not all drugs are eligible. To determine if a drug is eligible for coverage under Pharmacare, please ask a pharmacist or doctor, visit the online Drug Formulary Look Up or contact the Pharmacare office directly at 204-786-7141 or toll free at 1-800-297-8099.
A deductible is a specific dollar amount that must be paid each year before Pharmacare coverage begins. The minimum deductible for Pharmacare is $100, with no maximum deductible. Once an application has been processed, Pharmacare will send a notification letter indicating the deductible amount. To calculate a family deductible, please go to the online Pharmacare Deductible Estimator.
The deductible is based on Canada Revenue Agency income information from two years ago. Example: For the 2016/2017 Pharmacare benefit year, Pharmacare would use income information from the 2014 tax year.
The amount paid towards a deductible is tracked by the Drug Programs Information Network (DPIN) computer system. The system will automatically notify the pharmacist once a deductible is met. There is no requirement to submit prescription receipts or send payment for the deductible amount to Pharmacare. The DPIN system also checks each prescription against drug history to help protect Manitobans from adverse drug interactions.
A provision is included in The Prescription Drugs Cost Assistance Act, which allows for an adjustment to be made to the Pharmacare deductible if a family's income is reduced by more than 10 per cent in the 2016 calendar year.
Families with an income change of more than 10 per cent should complete a 2016/2017 Pharmacare Benefit Year Projected Income Worksheet and return it to our office along with required supporting documentation verifying the change in income. For more information, please call the Pharmacare office at 204-786-7141 or toll free at 1-800-297-8099.
The Deductible Instalment Payment Program for Pharmacare is an option for eligible Manitobans to pay their annual Pharmacare deductible in monthly instalments. This option will give Manitobans who have high monthly drug costs a way to pay their Pharmacare deductible in interest-free monthly instalments as part of their Manitoba Hydro energy bill.
The Deductible Instalment Payment Program for Pharmacare Guide and Application, Consent and Authorization Form are available online, by contacting the program at 204-945-1733 (in Winnipeg) or toll free at 1-888-519-3492 (outside Winnipeg), or at Manitoba pharmacies.
Manitobans 18 and older are assigned their own Manitoba Health Registration number and will receive a registration certificate in the mail. A Pharmacare Application and Consent Authorization Form should be completed and sent to the Pharmacare office for processing. Once the application has been processed, Pharmacare will send a notification letter indicating the deductible amount.
For Option A clients, Pharmacare deductibles will not be affected by pension income splitting. Pharmacare deductibles for the 2016/2017 benefit year are calculated using income from line 150 of the 2014 Canada Revenue Agency Notice of Assessment. When receiving income information from the Canada Revenue Agency, consideration has been given to pension income splitting and procedures are in place to allow for automatic line 210 deductions when applicable.
In the event that you have any questions or concerns please do not hesitate to contact us. Please Note: when contacting us via e-mail, please DO NOT include your Personal Health Information Number (PHIN) for security reasons.
For more information, please contact:
|Manitoba Health, Seniors and Active Living
Provincial Drug Programs
300 Carlton Street
Winnipeg, Manitoba R3B 3M9
Toll free: 1-800-297-8099
TTY/TDD Relay Service: 204-774-8618 outside Winnipeg: 711 or 1-800-855-0511