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"Point in Time" Regulation Content

Pharmaceutical Services Act

Drug Plans Regulation

B.C. Reg. 73/2015

NOTE: Links below go to reg content as it was prior to the changes made on the effective date. (PIT covers changes made from September 19, 2009 to present)
SECTIONEFFECTIVE DATE
Section 1 January 1, 2016
July 1, 2017
May 3, 2019
Section 3 May 3, 2019
Section 4 January 1, 2016
July 1, 2017
May 3, 2019
Section 6 July 1, 2017
Section 10 May 3, 2019
Section 23 May 3, 2019
Part 4 Division 2 January 1, 2016
July 1, 2017
May 3, 2019
Section 30 May 3, 2019
Section 31 May 3, 2019
Section 32 May 3, 2019
Section 35 May 3, 2019
Section 36 May 3, 2019
Section 37 May 3, 2019
Section 38 May 3, 2019
Section 39 May 3, 2019
Section 39.1 January 1, 2016
September 1, 2016
May 3, 2019
Section 39.2 July 1, 2017
April 1, 2019
May 3, 2019
Section 40 May 3, 2019
Section 40.1 May 3, 2019
Section 41 May 3, 2019
Section 42 November 14, 2017
May 3, 2019
Section 43 May 3, 2019
Section 44 January 1, 2016
Schedule 1 January 1, 2019
Schedule 2 January 1, 2019

 Section 1 definition of "personal representative" was added by BC Reg 221/2015, effective January 1, 2016.

 Section 1 definition of "Plan" BEFORE amended by BC Reg 221/2015, effective January 1, 2016.

"Plan" means a drug plan established under this regulation, those plans being Plans B, C, D, F, G, I, M, P and X;

 Section 1 definition of "Plan" BEFORE amended by BC Reg 93/2017, effective July 1, 2017.

"Plan" means a drug plan established under this regulation, those plans being Plans B, C, D, F, G, I, M, P, S and X;

 Section 1 definition of "Plan" BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

"Plan" means a drug plan established under this regulation, those plans being Plans B, C, D, F, G, I, M, P, S, W and X;

 Section 3 (1) (part) and (2) BEFORE amended by BC Reg 73/2019, effective May 3, 2019.

(1) A person is eligible to enroll in a drug plan if the person

(2) A person who is deemed under section 67 (2) (c) of the Act to be enrolled as a beneficiary in a drug plan continues to be enrolled in the corresponding drug plan, as defined in section 66 of the Act, until the beneficiary's enrollment ends under section 10 [when drug plan enrollment ends] of this regulation.

 Section 4 (3) (a) BEFORE amended by BC Reg 221/2015, effective January 1, 2016.

(a) Plan M according to the limits and conditions of Plan M only, and

 Section 4 (3) (a.1) was added by BC Reg 221/2015, effective January 1, 2016.

 Section 4 (4) (a.1) was added by BC Reg 93/2017, effective July 1, 2017.

 Section 4 (g) was added by BC Reg 98/2019, effective May 3, 2019.

 Section 6 (4) (a) BEFORE amended by BC Reg 93/2017, effective July 1, 2017.

(a) the FNHB program or the NIHB program, as those terms are defined in the Provider Regulation, or

 Section 10 BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

When drug plan enrollment ends

10   A person's enrollment in a drug plan ends on the earliest of the following dates:

(a) on the date the person ceases to be eligible to be enrolled in the drug plan;

(b) if the person gives notice to the minister stating the person's desire to cancel that person's enrollment, on the later of

(i) the date stated in the notice, if any, and

(ii) the date the notice is received by the minister;

(c) on the date set by the minister on cancelling the person's enrollment under section 10 (1) of the Act.

 Section 23 (1) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(1) Income-based coverage for a family unit continues each year until the family unit's enrollment in Plan I ends.

 Part 4, Division 2, heading BEFORE amended by BC Reg 221/2015, effective January 1, 2016.

Division 2 — Plans C, D, F, P and X

 Part 4, Division 2, heading BEFORE amended by BC Reg 93/2017, effective July 1, 2017.

Division 2 — Plans C, D, F, P, S and X

 Part 4, Division 2, heading BEFORE by BC Reg 98/2019, effective May 3, 2019.

Division 2 — Plans C, D, F, P, S, W and X

 Section 30 (3) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(3) A family unit is not eligible to enroll in the MDPO if

(a) a private insurer pays any part of the cost of benefits received by a member of the family unit, or

(b) a member of the family unit

(i) has been the subject of proceedings to recover a debt due to the government for failing to pay all or part of a monthly instalment, or

(ii) owes, at the time of applying to enroll in the MDPO, an amount equalling 3 or more monthly instalments, excluding interest and fees, if any.

 Section 31 (1) (a) and (b)BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(a) if the application to enroll in the MDPO is made on or before September 30, beginning the first day of the month that follows the month in which the application was made;

(b) if the application to enroll in the MDPO is made between October 1 and December 31, beginning January 1 of the following year.

 Section 32 BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

End of enrollment in MDPO

32   (1) A family unit's enrollment in the MDPO ends on the earliest of the following dates:

(a) December 31;

(b) if the registrant gives notice to the minister stating the registrant's desire to cancel the enrollment of the registrant's family unit in the MDPO, on the later of

(i) the date stated in the notice, if any, and

(ii) the date the notice is received by the minister;

(c) on the date set by the minister on cancelling the family unit's enrollment in the MDPO.

(2) The minister may cancel the enrollment of a family unit in the MDPO in any of the following circumstances:

(a) if a member of the family unit commits an offence under the Act;

(b) if

(i) the minister gives notice to the family unit that family unit owes an amount equalling 3 or more monthly instalments, excluding interest or fees, if any, and

(ii) the family unit does not pay the full amount owing within 30 days of the time stated in the notice;

(c) if the family unit has failed, as of March 1, to pay an amount owing toward a monthly instalment that

(i) was due in the previous year, and

(ii) totals more than $10.

(3) A family unit must, immediately on the end of enrollment in the MDPO, pay all amounts, including interest and fees, if any, owing toward monthly instalments.

(4) The total amount that a person is liable to pay under subsection (3) is a debt due to the government and may be

(a) deducted from any subsequent payment that may be made to the person under the Act, or

(b) recovered in a court of competent jurisdiction.

(5) On the end of enrollment in the MDPO, the minister must pay to the person who enrolled a family unit in the MDPO the amount by which the family unit's monthly instalment payments exceeded the cost of benefits paid by the minister under the Act, if that amount is $5 or more.

 Section 35 (2) (part) and (3) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(2) A person is eligible to enroll in Plan B if the person meets both of the following conditions:

(3) An eligible person's enrollment in Plan B begins on the date that the conditions under subsection (2) are met.

 Section 36 (2) (part) and (3) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(2) A person is eligible to enroll in Plan C if the person is one of the following:

(3) An eligible person's enrollment in Plan C begins on the date the minister receives notice of the person's eligibility from the applicable ministry of the minister responsible for the administration of an enactment referred to in subsection (2).

 Section 37 (2) (part) and (3) (part) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(2) A person is eligible to enroll in Plan D if the person meets both of the following conditions:

(3) An eligible person's enrollment in Plan D begins on the date the minister receives notice of the person's eligibility from a person acting on behalf of a cystic fibrosis clinic provided by one of the following:

 Section 38 (2) (part), (3) and (4) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(2) A person is eligible to enroll in Plan F if the person meets all of the following conditions:

(3) An eligible person's enrollment in Plan F begins on the date the minister receives notice of the person's eligibility from a director under the Child, Family and Community Service Act that the person is eligible to be enrolled in Plan F.

(4) Without limiting section 10 [when drug plan enrollment ends], a person's enrollment in Plan F ends on the last day of the month in which the person reaches 18 years of age.

 Section 39 (2) (part) and (3) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(2) A person is eligible to enroll in Plan P if the person meets all of the following conditions:

(3) An eligible person's enrollment in Plan P begins on the date the minister receives a copy of the certificate referred to in subsection (2) (c) from the certifying medical practitioner or nurse practitioner.

 Section 39.1 was enacted by BC Reg 221/2015, effective January 1, 2016.

 Section 39.1 (2) (b) BEFORE amended by BC Reg 221/2015, effective September 1, 2016.

(b) the person uses tobacco as that term is defined in the Tobacco Control Act;

 Section 39.1 (2) (part), (3) (part), (5), (6) and (7) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(2) A person is eligible to enrol in Plan S if the person meets all of the following conditions:

(3) An eligible person’s enrolment in Plan S begins on the date the minister first receives notice from a pharmacy provider, within the meaning of the Provider Regulation, of a declaration that

(5) Subsection (4) (b) applies regardless of whether, throughout the person's enrollment in Plan S, the same or different nicotine replacement therapies are used.

(6) Without limiting section 10 [when drug plan enrollment ends], a person's enrollment in Plan S ends on the earliest of the following dates:

(a) 84 days after the person's enrollment in Plan S begins;

(b) December 31 of the year in which the person's enrollment in Plan S begins.

(7) A person whose enrollment in Plan S ends may not enroll again in Plan S in the same calendar year.

 Section 39.1 (3) (c) (i) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(i) is eligible to enrol in Plan S, and

 Section 39.1 (4) (b) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(b) the minister may pay a claim made under Plan S only in respect of those nicotine replacement therapies dispensed before the person's enrollment in Plan S ends;

 Section 39.2 was enacted by BC Reg 93/2017, effective July 1, 2017.

 Section 39.2 (3) (c) (ii) BEFORE amended by BC Reg 68/2019, effective April 1, 2019.

(ii) a child, within the meaning of the Indian Act (Canada), of a person described in subparagraph (i), and who is less than one year of age.

 Section 39.2 (3) (part) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(3) A person is eligible to enrol in Plan W if the person meets all of the following conditions:

 Section 40 (3) and (4) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(3) A person is eligible to enroll in Plan X if the person is enrolled in the Drug Treatment Program.

(4) An eligible person's enrollment in Plan X begins on the date the person enrolls in the Drug Treatment Program.

 Section 40.1 was enacted by BC Reg 98/2019, effective May 3, 2019.

 Section 41 (2) (part) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(2) A person is eligible to enroll in Plan G if the person meets both of the following conditions:

 Section 42 (3) (b) BEFORE amended by BC Reg 208/2017, effective November 14, 2017.

(b) the person receives, or is eligible to receive, premium assistance under any of sections 11, 13 and 14 of the Medical and Health Care Services Regulation, and

 Section 42 (1) (part) BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

(1) An eligible person's enrollment in Plan G begins on the date the minister receives both

 Section 43 BEFORE amended by BC Reg 98/2019, effective May 3, 2019.

End of enrollment

43   Without limiting section 10 [when drug plan enrollment ends], a person's enrollment in Plan G ends on the earlier of

(a) the date, if any, stated in a certificate provided under section 42 (2) [conditions of enrollment] as the date on which enrollment should end, and

(b) one year after the minister receives both the certificate and declaration under section 42.

 Section 44 definition of "personal representative" BEFORE repealed by BC Reg 221/2015, effective January 1, 2016.

"personal representative" means a person having authority under the common law or an enactment to make decisions on behalf of a beneficiary;

 Schedule 1 BEFORE re-enacted by BC Reg 134/2018, effective January 1, 2019

Schedule 1

Plan I (No Registrant Born before 1940)

(section 20 [determination of deductibles and co-payments])

Column 1
Family Net Income ($)

(of registrant and spouse, if any)
Column 2
Family
Deductible ($)

(minister makes
no payment until
family unit pays
this amount)
Column 3
Maximum Family
Co-payment ($)

(after deductible is
paid, minister pays
70% until family
unit pays this
amount)
0.00 — 1 875.000.0025.00
1 875.01 — 3 125.000.0050.00
3 125.01 — 4 375.000.0075.00
4 375.01 — 6 250.000.00100.00
6 250.01 — 8 750.000.00150.00
8 750.01 — 11 250.000.00200.00
11 250.01 — 13 750.000.00250.00
13 750.01 — 15 000.000.00300.00
15 000.01 — 16 250.00300.00150.00
16 250.01 — 18 750.00350.00175.00
18 750.01 — 21 250.00400.00200.00
21 250.01 — 23 750.00450.00225.00
23 750.01 — 26 250.00500.00250.00
26 250.01 — 28 750.00550.00275.00
28 750.01 — 30 000.00600.00300.00
30 000.01 — 31 667.00900.00300.00
31 667.01 — 35 000.001 000.00350.00
35 000.01 — 38 333.001 100.00375.00
38 333.01 — 41 667.001 200.00400.00
41 667.01 — 45 000.001 300.00450.00
45 000.01 — 48 333.001 400.00475.00
48 333.01 — 51 667.001 500.00500.00
51 667.01 — 55 000.001 600.00550.00
55 000.01 — 58 333.001 700.00575.00
58 333.01 — 61 667.001 800.00600.00
61 667.01 — 65 000.001 900.00650.00
65 000.01 — 70 833.002 000.00675.00
70 833.01 — 79 167.002 250.00750.00
79 167.01 — 87 500.002 500.00850.00
87 500.01 — 95 833.002 750.00925.00
95 833.01 — 108 333.003 000.001 000.00
108 333.01 — 125 000.003 500.001 175.00
125 000.01 — 141 667.004 000.001 350.00
141 667.01 — 158 333.004 500.001 500.00
158 333.01 — 183 333.005 000.001 675.00
183 333.01 — 216 667.006 000.002 000.00
216 667.01 — 250 000.007 000.002 350.00
250 000.01 — 283 333.008 000.002 000.00
283 333.01 — 316 667.009 000.001 000.00
316 667.01 — 999 999 999.0010 000.000.00

 Schedule 2 BEFORE re-enacted by BC Reg 134/2018, effective January 1, 2019

Schedule 2

Plan I (At Least One Registrant Born before 1940)

(section 20 [determination of deductibles and co-payments])

Column 1
Family Net Income ($)

(of registrant and spouse, if any)
Column 2
Family
Deductible ($)

(minister makes
no payment until
family unit pays
this amount)
Column 3
Maximum Family
Co-payment ($)

(after deductible is
paid, minister pays
75% until family
unit pays this
amount)
0.00 — 3 000.000.0025.00
3 000.01 — 5 000.000.0050.00
5 000.01 — 7 000.000.0075.00
7 000.01 — 10 000.000.00100.00
10 000.01 — 14 000.000.00150.00
14 000.01 — 18 000.000.00200.00
18 000.01 — 22 000.000.00250.00
22 000.01 — 26 000.000.00300.00
26 000.01 — 30 000.000.00350.00
30 000.01 — 33 000.000.00400.00
33 000.01 — 37 500.00350.00350.00
37 500.01 — 42 500.00400.00400.00
42 500.01 — 47 500.00450.00450.00
47 500.01 — 50 000.00500.00500.00
50 000.01 — 52 500.001 000.00500.00
52 500.01 — 57 500.001 100.00550.00
57 500.01 — 62 500.001 200.00600.00
62 500.01 — 67 500.001 300.00650.00
67 500.01 — 72 500.001 400.00700.00
72 500.01 — 77 500.001 500.00750.00
77 500.01 — 82 500.001 600.00800.00
82 500.01 — 87 500.001 700.00850.00
87 500.01 — 92 500.001 800.00900.00
92 500.01 — 97 500.001 900.00950.00
97 500.01 — 106 250.002 000.001 000.00
106 250.01 — 118 750.002 250.001 125.00
118 750.01 — 131 250.002 500.001 250.00
131 250.01 — 143 750.002 750.001 375.00
143 750.01 — 162 500.003 000.001 500.00
162 500.01 — 187 500.003 500.001 750.00
187 500.01 — 212 500.004 000.002 000.00
212 500.01 — 237 500.004 500.002 250.00
237 500.01 — 275 000.005 000.002 500.00
275 000.01 — 325 000.006 000.003 000.00
325 000.01 — 375 000.007 000.003 000.00
375 000.01 — 425 000.008 000.002 000.00
425 000.01 — 475 000.009 000.001 000.00
475 000.01 — 999 999 999.0010 000.000.00