Accessing Provincial Coverage to Get Your Ostomy Products Covered | BC Fair Pharmacare and Others

I’ve been buying ostomy products for almost a decade now. When I was diagnosed with cancer in 2014, and again in 2017, I soon learned how expensive medications and supplies would be.  The first time I had to place a supply order, I got a bill for over $400.00 and almost fell over. I did not have benefits and wasn’t working as a result of illness. Here I was, just out of the hospital, my body not in good shape, my mental health struggling, and now facing financial hardship. As a single woman, I was fortunate to have a family to lean on until I sorted out things, which took me time. I don’t blame the nurses and doctors for not explaining/advising me about BC Fair Pharmacare; their main goal was to keep me and other patients alive, but a quick conversation would have been so appreciated.  I was also a little naive. As a Canadian, I expected my illness and new disability to be flagged and someone to call me.  Now I understand why that didn’t happen, but at the time was frustrated, scared and overwhelmed.

With this in mind, here’s a review of how to access BC Fair Pharmacare, whether you are fresh out of surgery or simply need help.

How to Get Provincial Insurance Coverage for Ostomy Products – BC Fair Pharmacare

Many of you reading this likely live in other Provinces across Canada, and I will do my best to speak to represent us all.  You’d think there would be some sort of consistent assistance program for all Canadians with a range of disabilities, but it’s not quite that simple. There is the Disability Tax Credit (DTC) for Canadians, which I will speak about a little bit later.

Ontario vs Manitoba

Each Province has different policies in place.  Ontario, for example, has a benefit sent out twice a year. I speak with Ontario ostomates quite often who don’t have additional benefits.  As much as this help is appreciated, it is not enough, and they have to pay the rest of their expenses.  Manitoba has decent coverage but is specific to the brand and issue with your ostomy life.  I spoke with a woman in Manitoba often who has a young child who previously had an ostomy.  This child was having a lot of issues with the brand provided, and I suggested she try another.  The mother told me that the only way to have access to the more expensive brands was if her daughter got so bad she couldn’t manage.

BC Fair Pharmacare

BC Fair Pharmacare sets the current year deductible based on income from your taxes two years prior.  Once the deductible is met, coverage help will come into effect, but you likely need financial help now. What I found out is that I could submit an income review application. I had no income coming in compared to 2 years prior and could not afford to pay for the supplies and medications I needed. This process can take some time, so the sooner you can get it submitted, the better. Here is the direct link for the BC Fair Pharmacare Income Review process.

Note: there are different tiers according to your income status. At the end of the year, Pharmacare deductibles reset, so it is recommended you order enough throughout the year and/or a larger order at year’s end.

Inner Good is a billing partner with BC Fair Pharmacare and ODSP in Ontario. If you have coverage or are unsure and want to see it, we ask you to state your date of birth and personal health care number in the order comment section. Upon receiving your order, we will enter the required Pharmacare information, and it will advise us how much of your order is covered.  At that time, a refund to your payment method will be processed. Like with most things, there are some exclusions.  Ostomy deodorant and lubricants are considered luxury items and, therefore, not covered.  How anything that helps us cope with our disability is a luxury is another conversation, but let’s take the wins where we can.

The Disability Tax Credit is available for all Canadians with a physical or mental impairment. I’ve heard some instances where people were denied the tax credit because the form was not properly filled out, be it an incomplete section or details too vague.  As much as I trust my doctor, I filled out the form before seeing him.  I only left the doctor-specific parts blank.  I made sure my printing was legible and that my life condition descriptions were enhanced.  No lies needed, just a more descriptive picture so I couldn’t be told I could manage and the tax credit denied.  My life has been forever changed, and I made sure that was clear.  In some instances, the tax credit can be backdated if you have not previously applied.  Further information about the DTC can be found on the Government of Canada website.

Another benefit for persons aged 59 and younger is the Registered Disability Savings Plan (RSDP). This savings plan is for people who have been approved for the DTC and meet the age requirements. More info on this is available here once again on the Government of Canada website. All this information can be overwhelming, and I highly recommend calling the CRA and speaking with someone.  They can easily send you information in the mail if you prefer that over a computer.

If you are finding shopping at the local pharmacy to be too expensive, you are not alone. Inner Good has affordable prices for Ostomy, Wound and Continence products for all the major medical brands and provides a first-purchase discount of 12% off our sales prices. Shop ostomy here or select from one of the brands below:

• Coloplast
• Hollister
• Convatec
• Salts
• Smith & Nephew
• 3M
• Medline

As patients, we go through so much. First, we learn we’re ill, then a treatment plan is set up, and now all this paperwork and income mess. If you are having a hard time navigating all of this, we are here to help. Contact me, Carly, at Inner Good anytime to ask me about everything mentioned above and any questions you may have about products. For those of you reading this from different provinces, please comment below and provide advice/tips on getting coverage in your province.

XOXO

Carly

Ostomate and the City on Instagram

2x Vulvar Cancer Survivor

Proud cat mom