Health and Community Services
October 11, 2007
New Prescription Drug Plan Provides Assurance for Residents with High Drug Costs
Residents of Newfoundland and Labrador financially burdened by high prescription drug costs will benefit from the Assurance Plan, a new initiative under the province’s Newfoundland and Labrador Prescription Drug Program (NLPDP). The Honourable Ross Wiseman, Minister of Health and Community Services, today announced details of the plan which comes into effect October 31, 2007.
"Our government has listened and acted upon the concerns brought forward by those who struggle to afford substantial medication expenses," said Minister Wiseman. "The new Assurance Plan is an important initiative that will significantly reduce the financial hardship faced by individuals and families with high drug costs."
The Provincial Government will invest approximately $17.5 million annually for the Assurance Plan, as announced in Budget 2007. It is estimated that approximately 14,400 families will benefit.
As the newest component of the Newfoundland and Labrador Prescription Drug Program, the Assurance Plan offers protection against the financial burden of eligible high drug costs, whether from the cost of one extremely high-cost drug or the combined cost of different drugs. Depending on their income level, individuals and families will be assured that their annual out-of-pocket costs for eligible drugs will be capped at a percentage of their net family income, as outlined in the table below.
As an example, a couple without children with a net family income of $35,000, no private insurance and annual eligible drug costs of $12,000 were previously not covered under the NLPDP. With the Assurance Plan, their new drug costs will be capped at five per cent of their net income, or $1,750 a year. This couple will save $10,250 each year.
"Our government has made the most substantial improvements to the prescription drug program in the history of this province, having increased the annual budget for the program by $53.5 million, with the current budget at $151 million," said Minister Wiseman. "Through this new plan and our other plans under the Newfoundland and Labrador Prescription Drug Program, we are providing significantly improved access to drug coverage for our residents."
Applications are available in physician’s offices and pharmacies as well as on-line at www.gov.nl.ca/health . Ads promoting the new Assurance Plan will be aired on the radio and in regional newspapers to encourage eligible residents to apply. Questions on the Assurance Plan can be directed to the Newfoundland and Labrador Prescription Drug Program Assessment Office at 1-888-859-3535.
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The Newfoundland and Labrador Prescription Drug Program
The Newfoundland and Labrador Prescription Drug Program provides financial assistance in the purchase of eligible prescription medications for those who reside in the province. There are four main plans under the program:
The Foundation Plan
The Foundation Plan provides 100 per cent coverage of eligible prescription drugs for those who need the greatest support. This includes persons and families in receipt of income support benefits through the Department of Human Resources, Labour and Employment, and certain individuals receiving services through the Regional Health Authorities, including children in the care of Child, Youth and Family Services, and individuals in supervised care. This plan was formerly known as the Income Support Program.
The 65Plus Plan
This plan provides coverage of eligible prescription drugs to residents 65 years of age and older who receive Old Age Security benefits and the Guaranteed Income Supplement (GIS). Coverage does not include professional (i.e. dispensing) fees. This plan was formerly known as the Senior Citizens Drug Subsidy Program
The Access Plan
The Access Plan gives individuals and families with low incomes access to eligible prescription medications. The amount of coverage is determined by net income level and family status. The program is available to:
This plan was formerly known as the Low Income Drug Program.
The Assurance Plan
This plan offers protection for individuals and families against the financial burden of eligible high drug costs, whether be it from the cost of one extremely high-cost drug or the combined cost of different drugs.
Depending on their income level, individuals and families will be assured that their annual out-of-pocket eligible drug costs will be capped at 5.0, 7.5 or 10 per cent of their net family income.
The NLPDP also provides 100 per cent coverage for disease specific medications and supplies for patients with Cystic Fibrosis and Growth Hormone Deficiency.
Frequently Asked Questions
What if I have private insurance?
If you have private insurance, you may still be eligible for the NLPDP. In this case, you are required to bill your private insurance first.
What drugs are covered by the NLPDP?
The program covers most drugs that require a prescription, plus a small number of other over-the-counter items that do not legally require a prescription. However, these products must be prescribed to be covered under NLPDP programs.
In addition, some drugs are covered under special authorization, meaning that certain criteria must be met. These require written requests by the prescriber which are then assessed by the Department of Health and Community Services.
Benefit lists for each plan are available at www.gov.nl.ca/health/nlpdp.
Does the program cover other medical expenses (e.g. eyeglasses)?
No. This program is only for coverage of eligible prescription drugs and a limited number of over-the-counter drugs.
How do I get my drug card?
If eligible, you will receive a drug card for you and each eligible member of your family in the mail. This card must be presented to your pharmacist with the prescription for the individual named on the card every time a prescription is filled.
Who is eligibile?
To be assessed for eligibility for any of the drug plans, you must be a Canadian resident residing in Newfoundland and Labrador and must meet the criteria for one of the plans under the program.
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