Benefits and Reimbursement

Nova Scotia Pharmacare

Benefits and Reimbursement

Below are some common questions and answers about program benefits and reimbursement for all Nova Scotia Pharmacare Programs.

Benefits Questions and Answers

What benefits does Pharmacare offer?

Are generic drugs dispensed under Pharmacare Programs?

What drugs and devices are not offered under the Pharmacare Programs?

What is the Nova Scotia Formulary?

Who makes the decisions regarding the benefit status of medications listed in the Nova Scotia Formulary?

What is an exception status drug and do you have a process to consider paying for drugs not listed as a benefit in the Nova Scotia Formulary?

How long does it take to review exception status drug requests?

How am I notified of the decisions regarding exception status drugs?

Once an exception status drug is approved, can the pharmacy bill Pharmacare for the cost of the medication?

Is eligibility for Nova Scotia Seniors’ Pharmacare Program contingent on giving consent to access your Canada Revenue Agency information or providing proof of income?

Reimbursement Questions and Answers

How are pharmacies reimbursed for medications dispensed to Pharmacare Program beneficiaries?

What drug cost does Pharmacare pay?

What is the Maximum Reimbursable Price (MRP)?

Are exemptions to the Maximum Reimbursable Price (MRP) considered?

What is the Pharmacare Reimbursement Price (PRP)?

Is there a limit on the quantity of drugs that will be reimbursed by the Pharmacare Programs?