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National Pharmacare (Plan NP) takes effect in B.C. on March 1
In this issue:
National Pharmacare (Plan NP) takes effect in B.C. on March 1
Travel coverage details plan members should know if they’re in or going to Mexico*
*Indicates content we will share with your clients.
National Pharmacare (Plan NP) takes effect in B.C. on March 1
The Province of British Columbia (B.C.) will implement the first phase of the National Pharmacare Act, also known as Bill C64 (Act), on March 1, 2026.
The new program will be called National Pharmacare (Plan NP). The province joins Manitoba and Prince Edward Island, who have already implemented the first phase of their own programs. All three provinces, along with Yukon, signed bilateral pharmacare agreements with the federal government last year.
National Pharmacare (Plan NP) coverage details
The federal government has agreed to provide universal coverage for many diabetes drugs and contraceptives, including deductibles, during the first phase of implementation of the Act. Equitable will no longer cover drugs that are eligible for coverage under Plan NP.
Diabetes devices and supplies are not included in the first phase of plan implementation. However, expanded coverage for certain diabetes-related devices and supplies is expected to begin in B.C. on April 1, 2026.
Since B.C. already offers universal coverage of contraceptives through its provincial pharmacare program, the province is using that portion of the federal funding to cover menopausal hormone therapy (MHT), also called hormone replacement therapy (HRT).
Many diabetes medications such as metformin, insulin, sulfonylureas and SGLT-2 inhibitors will be fully covered under Plan NP.
Some diabetes medications and MHTs will only be partially covered when the program takes effect. As well, many diabetes medications will continue to require Special Authority through the province.
What will Equitable plan members need to do?Coverage will be provided automatically at the pharmacy counter. Plan members simply need to present a prescription for a covered medication and their Medical Services Plan of B.C. (MSP) card to their pharmacist. If a plan member isn’t fully enrolled in the MSP yet, their pharmacist will help them secure coverage under Plan NP.
The pharmacist will charge the provincial plan directly for the relevant medications. There will be no direct impact to plan members or their experience at the pharmacy for fully covered drugs.
Where do GLP-1 drugs fit in?
GLP-1 agonist drugs will not be covered under Plan NP. Equitable plan members who are prescribed this type of drug to treat diabetes must try a first-line diabetic treatment before we can deem them eligible for coverage of the GLP-1 agonist.
Plan members who are already taking a GLP-1 agonist to treat diabetes will continue to be eligible for coverage. New plan members or plan members with new prescriptions for GLP-1 agonists must provide us proof that shows they’ve tried a first-line diabetic treatment to confirm eligibility—unless we already have a previous record of their insulin use. Proof can be either a past receipt or a claim statement.
Our priority is supporting the best outcomes for plan sponsors and their members. We are working with TELUS Health, our pharmacy benefits manager, to keep you updated as more details become available.
Travel coverage details plan members should know if they’re in or going to Mexico
Plan members with Travel Assist medical emergency coverage included in their benefits plan should keep the following information in mind if they’re planning travel to Mexico or if they’re in the country now.
Due to recent violence in Mexico, the Government of Canada has issued the following travel advice to anyone in or planning to visit the country.
Plan members are not covered if they receive out-of-province services where the Canadian government had issued a warning to avoid all or non‑essential travel before they entered the country.
Plan members should contact Trident Global Assistance, the company that administers our Travel Assist benefits, before departing if they have questions about their coverage or to confirm if they’re covered for travel to their specific destination.
Here’s how plan members can reach the Trident Global Assistance toll-free 24-hour emergency hotline:
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In Canada or the U.S: 1-800-321-9998
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Elsewhere: Call collect at 519-742-3287
They should be prepared to provide the following information:
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Name
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Group policy number
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Certificate number
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Government health insurance plan number
If a plan member arrived in Mexico before the travel advisory was issued and are past their day allowance, they should call Trident if they need to have their day maximum extended past the allowable period.
Equitable’s Travel Assist medical emergency coverage does not include any trip cancellation or trip interruption benefits.
Communicating to plan members
We are making every effort to share this information with affected plan members. Please encourage your clients who have Travel Assist coverage included in their benefits plan to share this message with their plan members.
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Equitable Life Group Benefits Bulletin – May 2021
In this issue:
- Graduating dependents losing coverage?*
- New Brunswick expands the use of biosimilars*
- Proposed changes to federal recovery and EI benefits*
- Removal of plan administrator access to update plan member banking*
- BioScript recognized as one of Canada’s Best Managed Companies*
Graduating dependents losing coverage?
Let plan members know about Coverage2go
As we reach the end of spring, some of your clients’ plan members may have dependents who are graduating from university or college and will no longer be eligible for coverage under the benefits plan.
Fortunately, we offer Coverage2go®. It allows individuals who are losing their group coverage to purchase personal month-to-month health and dental coverage that is affordable, reliable and works like their previous group benefits plan. They can choose the level of coverage and protection that suits their personal situation.
There are no medical questions – they simply need to apply within 60 days of losing their health coverage under their group benefits plan.*
Help your plan members and their dependents who are losing coverage by letting them know about Coverage2go. They can visit our website to learn more about Coverage2go and to get a quote.
*Quebec residents are not eligible for Coverage2goNew Brunswick expands the use of biosimilars
The New Brunswick government recently announced that it will be implementing a biosimilar transition program.
Patients using originator biologic drugs for diseases such as inflammatory arthritis, inflammatory bowel disease, diabetes and psoriasis, will have until November 30, 2021 to switch to the biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. This process will be completed in consultation with the patients’ physicians.
Biosimilars are highly similar to the drugs they are based on and Health Canada considers them to be equally safe and effective for approved conditions.
Equitable Life® actively monitors and investigates all biosimilar policy changes and the ongoing evolution of biosimilar drugs entering Canada. We will keep you informed of any impact on private drug plans and how we are responding.Proposed changes to federal recovery and EI benefits
In its recent 2021 budget, the federal government proposed a variety of changes to its benefit programs.
The proposed changes include providing up to 12 additional weeks of the Canada Recovery Benefit to a maximum of 50 weeks. The first 12 weeks of this benefit would be paid at $500 per week and the remaining eight weeks at $300 per week.
Multiple changes have also been proposed to make Employment Insurance (EI) more accessible to Canadians. The changes include: maintaining uniform access to EI benefits across all regions, supporting multiple job holders and those who switch jobs by ensuring that all insurable hours and employment count towards their eligibility, and simplifying many rules around EI to ensure Canadians can receive benefits sooner. It has also been proposed that the regular EI benefits be extended to no later than November 20, 2021, if needed.
We are analyzing the impact these changes may have to disability benefits. We will provide more details later in the year.Removal of plan administrator access to update plan member banking
In early June, plan administrators will no longer be able to update banking information for their plan members on EquitableHealth.ca after their initial enrolment. This change has been made to allow plan members to have full control over where they want their claim payments deposited.
Plan members can update their banking information online through their plan member web portal or through the EZClaim mobile app. They will continue to be notified via email if and when they make any changes.BioScript Solutions recognized as one of Canada’s Best Managed Companies
Congratulations to our partner, BioScript Solutions, for being recognized as one of Canada’s Best Managed Companies of 2021 by Deloitte.
We have partnered with BioScript since 2016 for our Specialty Drug Preferred Pharmacy Network (PPN). This partnership offers cost savings while providing comprehensive, best-in-class patient care.
BioScript is one of Canada’s leading specialty pharmacies and recently celebrated its 20th anniversary.
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