Eligibility & Programs
Family Health Benefit
This Program is for families who are:
- registered with Medicare
- have at least one child under 18 years of age
- a total annual net family income of less than $22 000, plus $2000 for each additional child under 18
Families must apply for this program.
Financial Assistance Program
This program provides coverage for Islanders eligible under the Welfare Assistance Act and Regulations.
Remicade and Enbrel Program
To be approved for this program, you must be eligible for PEI Medicare and diagnosed with:
- severe active Rheumatoid Arthritis OR
- severe active Juvenile Rheumatoid Arthritis OR
- severe Crohn’s disease OR
- fistulizing Crohn’s disease.
Seniors’ Drug Cost Assistance Program
To be eligible for this program, you must be eligible for PEI Medicare and at least 65 years old. You do not need to apply; you will be automatically registered when you turn 65 years old.
PEI also has the following other programs:
Coverage
Family Health Benefit Program
Families will pay only the pharmacy professional fee for each approved prescription medication.
Financial Assistance Program
There are no fees, and all approved prescription and non-prescription medications are covered.
Remicade and Enbrel Program
If approved, all approved prescription medications will be covered. You pay the pharmacy professional fee and an income-based portion of the medication cost of each prescription.
Seniors’ Drug Cost Assistance Program
If covered by this program, you will pay the pharmacy professional fee and the first $11 of the medication cost for all approved prescription medications.
Supply Limits
Due to safety and wastage concerns, the PEI Drug Programs will pay for Maximum Allowable Days Supply levels. These levels vary depending on which program you are enrolled in; typically they are for 30-60 day supplies.
Least Cost Alternatives
Unless granted special authorization, clients must pay any cost difference between the generic/least expensive alternative and a requested brand name product.
Exception Drug Status
Some drug products may be considered for EDS under the following circumstances:
- the drug has the potential for widespread inappropriate use
- therapeutic alternatives listed in the Formulary are ineffective or contraindicated
- there is no alternative in the Formulary
- the medication has been reviewed by either the Atlantic or Canadian Expert Advisory Committees
Applications for EDS should be processed by the physician, and may take a minimum of four weeks to process.
Contact Information
Drug Program Manager
Drug Cost Assistance Plan
Department of Social Services and Seniors
PO Box 2000
Charlottetown, PEI
C1A 7N8
(902) 368 4947 (in Charlottetown)
1 877 577 3737 (toll free in PEI)
Forms and Links
Program Application (PDF file)
Remicade for Moderate-Severe Active Crohn
