Pharmacare & Extended Health Care Benefits
The Pharmacare and Extended Benefits program is designed to assist registered senior citizens with the cost of dental care, eye care, medical-surgical supplies and equipment and drug costs. The program will pay the total costs of the lowest priced generics of all prescription drugs listed in the Yukon Pharmacare Formulary, including the dispensing fee.
To qualify for the program, an individual must be a Yukon resident at least 65 years of age, or 60-years-old, and married to a living Yukon resident who is 65 years or older.
Eligibility
To be eligible for benefits you must be registered with the Yukon Health Care Insurance Plan (YHCIP).
If you are already registered with YCHIP, you will automatically be sent an application form during the month you turn 65. A green Pharmacare card will be issued to you once the application form has been returned and processed. It will take approximately three weeks for the card to be processed and returned.
If you have only recently moved to the Yukon, you must first register with YHCIP. The application form for Pharmacare and Extended Benefits can be filled in at the same time and a Pharmacare card will be issued to you once the registration process has been completed. It takes three months for your YHCIP coverage and seniors benefits to begin if you are new to the Yukon.
The Pharmacare card confirms your eligibility for all insured physician and hospital benefits, and seniors’ benefits.
Benefits
If you receive health insurance benefits through your employer or a third party insurance agency, all claims must first be submitted to them first. The Pharmacare program is the insurer of last resort.
The Pharmacare program will pay the total cost of the lowest priced generics of all prescription drugs listed in the Yukon Pharmacare Formulary, including the dispensing fee.
The program such as also covers certain non-prescription drugs and goods:
- Compounds used in the control of heart disease; nitroglycerin preparations, digoxin and other digitalis related products
- Anti-inflammatory drugs; analgesics used for the symptomatic relief of arthritic conditions
- Insulin syringes
Extended Health
Benefits include partial or 100 per cent coverage of the following benefits:
- Medical-Surgical Supplies/Equipment – the plan may provide walking aids, hand inhalers, artificial eyes and limbs, respiratory equipment, commodes and manual wheelchairs
- Hearing Aids – one hearing aid or a replacement hearing aid is allowed in a four-year period. Repair and adjustment of hearing aids is allowed once every six months. Batteries are not covered.
- Dental Care – the plan may pay for dentures or rebases once in a five-year period. Coverage is limited to $1400 in any two-year period. You may present your Pharmacare card to the dentist and they can submit the bill directly to the health care plan for payment
Amounts above the $1400 are your responsibility to pay.
Should you require high cost procedures, you should sign an application form and have the dental clinic submit it to the program for prior approval.
- Eye Examination and glasses – the plan may pay for one eye examination, new lenses and a maximum of $100 towards the purchase of frames once every two years. Benefits do not include the repair of glasses. The purchase of tinted or contact lenses is not covered unless medically necessary. If your physician deems an eye examination is medically required, the cost of the appointment will be covered even if within the two-year period.
You will be charged directly for the cost of drugs if you do not have your Pharmacare card with you when making a purchase. The program upon receipt of original bill may refund this amount.
Drugs purchased outside of the territory must be paid for directly. Refunds may be provided upon return to Yukon provided original receipts are provided.
Restrictions
Yukon Pharmacare does not cover the cost of products which can be obtained without a prescription, including vitamins, patent medicines, personal care items, medical-surgical supplies, laxatives, antacids and most medicines used in the treatment of colds.
Persons receiving benefits under these programs are not longer eligible fi they are absent from the Yukon for more than 183 days, unless the absence is for less than 210 days and the beneficiary has satisfied the director that the Yukon is his or her permanent residence.
If you move out of the territory, benefits cease on the day of departure.
Although Yukon Pharmacare covers your prescription drugs, it is an offence to receive benefits under the plan for someone else’s use.
If you are a member of Yukon Pharmacare but also have coverage under another drug program, it is an offence to seek full reimbursement from both plans.
Yukon Pharmacare and Extended Benefits Program
4th floor, Financial Plaza
204 Lambert Street, Whitehorse
876-667-5403
Toll free 1-800-661-0408, local 5403 (Yukon only)