Family Health Benefit Drug Program
If you are a low-income family, you may qualify for the Family Health Benefit Drug Program which helps cover the cost of approved prescription medications for you and your children if they are under the age of 19 or under the age of 25 and a full-time student.
Am I eligible?
You are eligible for the program if you:
- are a permanent PEI resident as defined by the Drug Cost Assistance Act;
- have a valid PEI Health Card; and
- are a low-income family supporting at least one child in the approved age categories.
How do I apply?
- Submit a completed Family Health Benefit Application form [PDF | 471 KB].
- If you are including a dependant under the age of 25 who is a full-time student, proof of enrolment from the educational institution must accompany your application.
- If joint custody of the qualifying child exists, both parents may apply to the program.
How much of the medication cost will be covered?
Assistance is based on family size and household income. While the program will cover the full cost of medication, you must pay the pharmacy dispensing fee.
- If you have 1 child, your net annual family income to qualify must be less than $24,800
- If you have 2 children, your net annual family income to qualify must be less than $27,800
- If you have 3 children, your net annual family income to qualify must be less than $30,800
- If you have 4 children, your net annual family income to qualify must be less than $33,800. If you have more than 4 children, add $3,000 for each additional child
When will coverage begin?
If approved, your coverage will begin on the date noted in your approval letter, and will continue until September 30. You must re-apply each year before your coverage expires.
Coverage ends when you have no children under the age of 19 or under the age of 25 who are full-time students.
What if my medication is not listed in the PEI Pharmacare Formulary?
Some medications in the PEI Pharmacare Formulary are approved on a special authorization basis only. If your physician prescribes a drug in this category, he or she can submit a Standard Special Authorization Request form [PDF | 34 KB] to have a medication considered for coverage.
If your medication is not included in the PEI Pharmacare Formulary, it will not be eligible for coverage.
What if I have private insurance?
You or your pharmacy must submit all claims to your private insurer first. The remaining out-of-pocket eligible expense can then be submitted to PEI Pharmacare for assessment.
Where can I get my medication?
You can fill your prescription at any community retail pharmacy located in Prince Edward Island.
Will I get a refund for medication I already purchased?
Coverage is not retroactive, you will not be reimbursed for medications you have already purchased.
Will my medications be eligible for coverage if they are filled at an out of province pharmacy?
Claims are eligible for manual submission only if the medication or any formulation of the medication cannot be dispensed through a PEI pharmacy
What if I move away from PEI?
Your eligibility for this program will end the day you leave PEI to take up residency elsewhere.
Who can I contact for more information?
16 Fitzroy Street
Charlottetown, PE C1A 7N8
Telephone: (902) 368-4947
Toll free: 1-877-577-3737