What Is PharmaCare?

BC PharmaCare is a government-funded program that helps cover the cost of prescription drugs and certain medical supplies, based on income. It’s a vital support system for many British Columbians, especially those who rely on long-term or high-cost medications.

Key things to know about PharmaCare:

• Income-based coverage: The amount of coverage clients receive depends on their net family income from two years ago, so it’s important to understand how income affects eligibility.
• Deductible first: Clients need to pay the full cost of eligible medications until they reach their annual deductible. After that, PharmaCare covers 70% of the cost.
• Full coverage kicks in: Once clients reach their maximum out-of-pocket amount for the year, PharmaCare covers 100% of eligible prescription costs.

Why this matters to your clients — and your sales conversations:

Many clients assume public drug coverage kicks in right away or covers everything, but that’s not the case. With PharmaCare’s deductible-first model, many families and seniors end up paying significant out-of-pocket costs before any help begins. That’s where private plans can really add value and make a meaningful difference.

How Pacific Blue Cross Individual Plans work with PharmaCare:

• Coverage right away: Clients can submit eligible prescription claims through their Pacific Blue Cross plan immediately, even before they hit their PharmaCare deductible. This helps reduce out-of-pocket expenses early in the year.
• Faster access to PharmaCare: Those same expenses are tracked and count toward the PharmaCare deductible, helping clients qualify for public coverage sooner.
• Less financial pressure: This coordinated approach reduces financial stress, especially for clients managing chronic conditions or ongoing prescriptions.

Advisor tip:

Don’t just position private health coverage as a nice-to-have. Frame it as a smart way to bridge the gap between what public coverage offers and what your clients truly need. For families, retirees, or anyone with recurring medication costs, having both public and private plans working together can provide real, immediate financial relief. It makes your recommendation more compelling and easier for clients to say yes to.

Use the PharmaCare Calculator to help clients find the right level of coverage for their needs.