High Cost Drug Program
If you need assistance paying for medications, you may be eligible for coverage of approved medication costs through the High Cost Drug Program.
Am I eligible?
To be eligible for coverage and qualify for assistance according to your household income, you must:
- be a permanent resident of PEI as defined by the Drug Cost Assistance Act;
- have a valid PEI Health Card; and
- have filed your family's most recent income tax return in PEI
You may be eligible for coverage for approved medication costs for several medical conditions, including but not limited to:
- Ankylosing Spondylitis;
- Crohn's Disease;
- Multiple Sclerosis;
- Plaque Psoriasis;
- Pulmonary Hypertension;
- Psoriatic Arthritis;
- Rheumatoid Arthritis; and
- Wet Age-Related Macular Degeneration
If your medical condition is:
You may be eligible for coverage of approved medication costs if you have been diagnosed with relapsing-remitting or progressive Multiple Sclerosis. Complete the High Cost Drug Program Application Form [PDF | 33 KB]. Your neurologist must complete your Multiple Sclerosis Medications Special Authorization Request Form [PDF |155 KB].
How do I apply?
- Submit a completed High Cost Drug Program Application form [PDF | 33 KB].
- Your physician or diagnosing specialist must submit a completed Special Authorization Request form, and any appropriate medical information on your behalf.
- You must re-apply for coverage two months prior to your expiry date.
- Your eligibility for coverage and level of co-payment will be confirmed in writing.
How much of the medication cost will be covered?
Your cost of the medication will depend on your household income. You must also pay a pharmacy professional fee, which may vary with each pharmacy. The remainder of the medication cost will be paid to the pharmacy directly.
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. You will receive up to a 30-day supply of medication.
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.
What if I move away from PEI?
Your eligibility for this program will end the day you leave PEI to take up residency elsewhere.
How can I contact PEI Pharmacare?
16 Fitzroy Street
Charlottetown, PE C1A 7N8
Telephone: (902) 368-4947
Toll free: 1-877-577-3737