Manitoba Pharmacare Program Information:
2006-2007
Pharmacare is
a drug benefit program for any Manitoban, regardless of age, whose income
is seriously affected by high prescription drug costs. Pharmacare coverage
is based on both your total family income and the amount you pay for eligible
prescription drugs. Each year you are required to pay a portion of the
cost of your eligible prescription drugs. This amount will be your annual
Pharmacare deductible. Pharmacare sets your deductible based on your annual
family income. 
You qualify
if you meet all of the following criteria:
-
You are eligible
for Manitoba Health coverage.
-
Your prescriptions
are not paid through other provincial or federal programs.
-
Your prescription
costs are not covered by a private drug insurance program.
-
Your eligible prescription
drug costs exceed your Pharmacare deductible.
There are two ways to
apply. The recent advancements in electronic data exchange
technology now make it possible for Manitoba Health to verify income
information directly from Canada Revenue Agency.
Therefore, the Pharmacare Program is now able to implement a system
whereby Manitobans do not have to apply to Pharmacare for benefits on
an annual basis.
Option A--One-Time Enrolment
The revised application system affords Manitobans
the choice of a one-time program enrolment. The one time program enrolment eliminates the need to
submit, on an annual basis, a completed application form that includes
validation of income. In addition, the revised system facilitates an electronic data exchange to establish the annual
deductible on April 1 of each benefit year. Canada
Revenue Agency electronically forwards to Manitoba Health the most
recent income information available; i.e., 2004 income level will
determine the annual Pharmacare deductible for the 2006/2007 benefit
year. In short, Manitobans are no longer required to annually
submit a Pharmacare application along with income verification.
Please note that you may make application to the
program anytime during the benefit year April 1 to March 31.
Manitobans that choose to withdraw from the one time program enrolment
must do so in writing to the Provincial Drug Programs.
Option B - Annual
Application
Fill out and sign
both the Consent and Declaration sections of the new
Pharmacare Application and Consent Authorization Form and send it to
Manitoba Health along with copies of your 2004 Canada
Revenue Agency Notice
of Assessment indicating the total income shown on line 150.
To register for coverage, you must re-apply each year. The
Pharmacare benefit year is April 1 to March 31. You may apply any time
during the benefit year. March 31, 2007 is the last day to submit
applications for the 2006/2007 benefit year.
Commonly-Asked Questions for Option B
What is
a Notice of Assessment?
The Notice of
Assessment is a summary of your tax information sent to you by Canada Revenue Agency after your tax return is processed. It will be attached to your
refund cheque or statement.
My tax
information is confidential. Why do you need a copy of my Notice of Assessment?
Pharmacare is
an income-based program and requires this information in order to verify
and process your application. Pharmacare has taken the necessary steps
to protect your privacy and the confidentiality of your personal information.
My spouse
and I file our taxes together on one return. Do we have to send you anything
different?
Pharmacare requires proof of your spouse's income. One
acceptable document is a copy of the Canada
Revenue Agency Schedule 2 "Amounts
Transferred From Spouse," from your working copy of your tax return.
What if
my Notice of Assessment has been lost or destroyed?
You may contact Canada Revenue Agency for a certified printout at (204) 984-3188 or toll free 1-800-808-4278.
The certified printout should indicate the amount on line 150.
If you file a joint income
tax return with Canada Revenue Agency: (1) you
must indicate this to Canada Revenue Agency when requesting a certified printout
for you and your spouse, and
(2) Canada Revenue Agency will require identifying information for both spouses before they
will release your spouse's information.
Click here to download the
new Pharmacare Application and Consent Authorization Form
(Note: to view this file, you must have the
Adobe Acrobat Reader installed on your computer. If you don't have the Adobe Acrobat Reader installed on your computer,
please click here:
The completed authorization can be forwarded to the
Provincial Drug Programs, 300 Carlton Street, Winnipeg, MB R3B 3M9 or
faxed to (204) 786-6634.
In the event that you have any questions or concerns
please do not hesitate to contact the Provincial Drug Programs at
(204) 786-7141 or toll free at 1-800-297-8099.
What happens
when I become 18 years of age?
You receive
your own Manitoba Health registration certificate. You should fill in a
Pharmacare application and send it to Manitoba Health for processing. Pharmacare
will send you a letter confirming your deductible.
Does the
computer system still keep track of my drug history?
Yes, this is
an important function of the computer system also known as DPIN (Drug Programs
Information Network). The system checks each prescription against your
drug history to help protect you from adverse drug interactions.
What do
you mean by deductible?
Once your application
has been approved, Pharmacare will send you a letter confirming your deductible.
The portion is the amount you pay. Once you have reached your deductible,
Pharmacare will pay for 100% of your eligible prescription drugs. Your deductible will be tracked by the DPIN system automatically.
It is
not necessary to send Pharmacare a cheque.
How does
my pharmacist know when I meet my deductible?
The Pharmacare
system still updates your prescription records on the DPIN. It keeps track
of the amount you pay for eligible prescription drugs. Once your application
is processed, your deductible is set and the computer will tell the pharmacist
the amount you must pay.
What
do you mean by an eligible prescription drug?
An eligible
drug is one that is covered by Pharmacare. If you are unsure whether your
prescription is eligible you should ask your pharmacist or doctor, or contact
Pharmacare.
What
do I do with my receipts that I get from the pharmacy? Do I send them to
Pharmacare?
No, although
you may wish to keep the receipts for your records. Some individuals have
private insurance or may claim medical expenses on their income tax. If
you are not sure, contact Pharmacare. The only time you should send us
your receipts is when the prescription information could not be sent by
the computer: for example, if you have prescriptions from outside Manitoba
but within Canada.
Can my Pharmacare deductible be changed if my income has dropped
this calendar year?
A provision is included in The Prescription Drugs Cost
Assistance Act, which allows for an adjustment to be made to the
Pharmacare deductible in the event that a family's income is
reduced by greater than 10% in the 2006 calendar year. The reduction
of income from 2004 to 2006 must exceed 10%.
Families with an income change, greater than 10%, should
complete a 2006/2007 Pharmacare Benefit Year
Projected Income Worksheet. Families who qualify for an
amendment to their 2006/07 Pharmacare must complete the Projected
Income Worksheet and return it to our office along with required
supporting documentation. For more information on how to
"project" your income, please call our office.
Click here to download the 2006/2007 Pharmacare Projected Income Worksheet.
Please note: you will need the Adobe Acrobat Reader to
view the above PDF document. If you do not have the Adobe
Acrobat Reader installed on your computer, please click here:
The completed worksheet and all supporting documents can be
forwarded to the Provincial Drug Programs, 300 Carlton Street,
Winnipeg, MB R3B 3M9 or faxed to (204) 786-6634.
In the event that you have any questions or concerns please do not
hesitate to contact the Provincial Drug Programs at (204) 786-7141 or
toll free at 1-800-297-8099.
For
more information about the
Manitoba Pharmacare Program,
please contact:
Manitoba Health
Provincial Drug
Programs
Ph. (204) 786-7141
or toll-free at 1-800-297-8099
E-mail: pharmacare@gov.mb.ca
When contacting us via e-mail, please
do not send us your Personal Health Information
Number (PHIN) for security reasons--any information you attempt to submit is
not secure and could be observed by another party while in transit.
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