Eligibility for PDP
The PDP provides prescription drug benefits to 10 eligible groups. Some of the groups, their identifying letter and their eligibility requirements follow. All require registration with NB Medicare.
A - Seniors
- 65 years or older
- receiving the federal Guaranteed Income Supplement OR
- meet low-income requirements
E - Licensed Residential Facilities
- must be a resident in a licensed adult residential facility
- status is determined by the Department of Family and Community Services
F - Family and Community Services
- individuals who hold valid health cards from the Department of Family and Community Services
- status is determined by the Department of Family and Community Services
G - special needs children; children in care of the state
- children in the care of the Minister of Family and Community Services OR
- special needs children
- status is determined by the Department of Family and Community Services
R - organ transplant
- individual must have received an organ or bone marrow transplant
- must not be eligible for similar benefits from another source
- NB Organ Procurement Officer notifies the PDP
V - nursing home
- residents of registered nursing homes
- eligibility determined by Department of Family and Community Services
PDP Co-pays
A - Seniors on GIS
- $9.05 per prescription
- maximum of $250 in one year
A - Seniors qualifying by income
- $15.00 per prescription
- no yearly maximum
E - Licensed Residential Facilities
- co-pay is $4.00 per prescription
- maximum $250 per person per fiscal year
F - Family and Community Services
- co-pay of $4.00 per prescription for adults
- co-pay of $2.00 per prescription for children under 18 years old
- maximum od $250 per family unit per fiscal year
G - special needs children; children in care of the state; V - nursing home
- no co-pays or fees
R - organ transplant and U - HIV
- co-pay is 20% of cost of each prescription, up to $20
- fiscal year maximum is $500 per family unit
- yearly registration fee of $50
Excluded Drug Products on the PDP
While covered drug products are listed in the Formulary, particular drugs are specifically excluded from coverage. These include, but are not limited to, the following:
- non-prescription acetysalicylic acid preparations except designated enteric-coated ASAs
- non-prescription preparations, except those listed as benefits for group G
- non-prescription adult vitamins/multivitamins as dietary supplements for plans A, E, and F
- dietary supplements and weight loss products
- laxatives for plans A, E, F and G
- antacids for plan A
- drugs or products for solely cosmetic use
- appliances, devices, medical supplies and prostheses
Special Authorization
Application must be made by physician on behalf of patient, including all clinical and diagnostic evidence supporting the use of the SA drug. Decisions are made on a case-by-case basis.
Dispensing Fee Maximums
Prescription Cost Dispensing Fee Dispensing Fee for Compound
Up to $99.99 8.40 12.60
$100 - 199.99 10.90 16.35
$200 - 499.99 16.00 17.00
$500 - 999.99 21.00 21.00
$1000 - 1999.99 61.00 61.00
$2000 - 2999.99 81.00 81.00
$3000 - 3999.99 101.00 101.00
$4000 - 4999.99 121.00 121.00
$5000 - 5999.99 141.00 141.00
$6000 and up 161.00 161.00
Contact Information
Prescription Drug Program Administration Office
PO Box 690
Moncton, NB
E1C 8M7
Phone: (506) 867 4515
Toll Free: 1 800 332 3692
Email: BC_nbpdp@medavie.bluecross.ca
Forms and Links
Low Income requirements for Seniors
Drugs excluded from coverage.
