Deductible Instalment Payment Program for Pharmacare
Many Manitobans need prescription drugs to manage their illnesses. In some cases, a single prescription can be as much and sometimes more than a family’s annual deductible amount. The Deductible Instalment Payment Program for Pharmacare helps reduce financial hardship for individuals and families whose eligible drug costs are a significant portion of their monthly family income.
The Payment Program 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 compared to their monthly income a way to pay their Pharmacare deductible in interest-free monthly instalments as part of their monthly Manitoba Hydro energy bill.
The financing program is administered by Manitoba Health. Manitoba Hydro also participates in the program. Its role is to withdraw monthly payments from your account with your bank or credit union for the bill payment portion of the program.
To be considered for the program, applicants and/or their families must:
- First be enrolled with the Manitoba Pharmacare program;
- Have eligible Pharmacare specified drug costs over a 30-day period that are equal to or above 20 per cent of their average monthly adjusted family income;
- Have, as of the application date for enrolment in the program, reached or gone above their benefit limit for specified prescription drug coverage through another drug insurance or benefit plan*; and
- Pre-authorize Manitoba Hydro to make automated monthly withdrawals from their bank or credit union account to pay for their Pharmacare annual deductible by way of monthly instalments as well as their monthly Manitoba Hydro energy bill.
* Other health and/or drug coverage that contributes towards or pays your prescription drug costs. Participation in the program could complicate and/or delay the reimbursement of those other benefits. You may be eligible to apply once all other benefits have been exhausted.
If you are not currently a Manitoba Hydro customer or do not receive a monthly Manitoba Hydro energy bill, an account can be set up to issue monthly billings for the monthly instalments of your Pharmacare annual deductible.
How to Apply
The Deductible Instalment Payment Program for Pharmacare Guide and Application, Consent and Authorization Form are available online, by contacting the Payment Program at 204-945-1733 (in Winnipeg) or toll free at 1-888-519-3492 (outside Winnipeg), or at Manitoba pharmacies.
You must fully complete, sign and date the Application, Consent and Authorization Form and return the completed form to your pharmacy. Your pharmacy will estimate your monthly drug costs. Your pharmacy will then fax and mail the original copy of the form to the Payment Program for processing, normally within five business days.
Once your application is processed, you will be sent a letter telling you if you have been approved for enrolment in the program. If you are approved, the letter will also give the amount of your pre-authorized monthly withdrawal.
Frequently Asked Questions
What is the payment program?
The Deductible Installment Payment Program for Pharmacare is an interest-free financing program for Manitobans who face high drug costs compared to their estimated average monthly income. It offers eligible Manitobans a way to pay their Pharmacare annual deductible in monthly installments.
What are the eligibility requirements to participate in the payment program?
To be considered for the payment program, the applicant or their family must:
- first be enrolled with the Manitoba Pharmacare program;
- have eligible Pharmacare specified drug costs over a 30-day period that are equal to or above 20 per cent of the average monthly adjusted family income;
- have, as of the date of their application for enrolment in the program, reached or gone above their benefit limit for specified prescription drug coverage through another drug insurance or benefit plan*; and
- pre-authorize Manitoba Hydro to make automated monthly withdrawals from their bank or credit union account to pay their Pharmacare annual deductible by way of monthly installments as well as their regular Manitoba Hydro energy bill.
*Other health and/or drug coverage that contributes towards or pays your prescription drug costs. Participation in the program would complicate and/or delay the reimbursement of those other benefits. People may be eligible to re-apply for the payment program once all other benefits have been exhausted.
How high does a person’s drug costs need to be to qualify?
An individual’s eligible Pharmacare drug costs over the next 30 days must equal or exceed twenty (20) per cent of their estimated average monthly family income. The assessment for eligibility is made by the Payment Program.
How do individuals pay their deductible if they enrol in the program?
Currently, individuals pay their Pharmacare deductible in full at the pharmacy as they make their prescription purchases. Those with high eligible drug costs can continue to pay their deductible at the pharmacy or apply for the program. If they are eligible for enrolment in the program, the patient will not have to pay for any prescriptions at the pharmacy for eligible drug benefits.
Instead, the deductible will be billed through a monthly installment amount that appears on the applicant’s monthly Manitoba Hydro energy bill and is paid by pre-authorized automated withdrawals from the enrollee’s bank account.
If patients qualify for the payment program and currently do not receive a Manitoba Hydro energy bill, Manitoba Hydro will set up an account for the purposes of billing the payment of the monthly deductible installment amount.
Manitoba Health |