Frequently Asked Questions
- Who is eligible for the plan?
- How do I enroll?
- How do I apply for drug coverage if I am moving to New Brunswick?
- Do I need to enroll in the New Brunswick Drug Plan if I am covered by the New Brunswick Prescription Drug Program (NBPDP)?
- What if I have a pre-existing medical condition?
- Does my spouse have to enroll too?
- Who can be included as a dependant?
- Why do dependants who are 16 to 18 years old need to give consent for their personal health information to be shared?
- Can I add or remove a family member from the plan?
- How do I change my personal or payment information?
- Can I withdraw my application if I decide not to enroll?
- How do I cancel my membership?
- If I have other drug coverage, do I need to submit information annually?
- Will my coverage be cancelled every year when my private plan’s maximum annual coverage is reset?
- Do I need to let you know if my private drug coverage information changes?
- Does this plan cover every drug on the market?
- What is the process for a drug to be listed as a benefit?
- Does this drug plan cover expensive drugs?
- Is the cost of a brand name drug covered if a generic product exists?
- What if a member needs a drug that is not on the Formulary?
- Does the New Brunswick Drug Plan cover more than prescription drugs?
- Does the New Brunswick Drug Plan cover cannabis or cannabis products such as cannabidiol (CBD) oil?
Cost to Members (Premiums and Copayments)
- What is the cost of the plan to members?
- How are the premiums determined?
- When is the premium payment due?
- If one member in the family enrolls, would the premium be based on the individual income or the family income?
- What is the definition of income? Does it include RRSPs, CPP, investment income, etc.?
- How often are the premiums reassessed?
- Can I request a reassessment of my income at any time?
- What if I don’t file tax returns?
- Are premiums and copayments tax-deductible?
- Will there be changes to the Plan design?
The New Brunswick Drug Plan is available to New Brunswick residents who have an active Medicare card and meet one of the following requirements:
- Do not have drug coverage through a private plan or other government program, or
- Have other drug coverage with a private plan; however,
- They have reached the annual or lifetime maximum for drug coverage with the plan, or
- They have been prescribed a drug that is not listed on their private plan formulary for the prescribed condition (indication).
Before applying, contact the New Brunswick Drug Plan Information Line at 1-800-332-3692 to confirm that the requested drug is included in the New Brunswick Drug Plans Formulary.
If you have no other drug coverage
Complete an application form and mail or fax it to the address indicated on the form. If you would like a form mailed to you, call the New Brunswick Drug Plan Information Line at 1-800-332-3692.
If you have other drug coverage
Complete the forms outlined below and mail or fax them, along with the additional information required, to the address provided on the form. If you would like a form mailed to you, call the New Brunswick Drug Plan Information Line at 1-800-332-3692.
Enrollment information required for those with other drug coverage:
- Completed application form
- Completed Supporting Application Form for those with Other Drug Coverage
- A letter from your private plan confirming that:
- The drug you have been prescribed is not listed on the private plan’s formulary for the condition (indication) prescribed,
- You have reached the annual or lifetime drug maximum with the private plan.
- A completed special authorization request (if applicable).
The New Brunswick Drug Plan will not consider requests for coverage because you do not meet your private plan’s reimbursement criteria for the prescribed condition (indication).
In all instances, the New Brunswick Drug Plan is a payor of last resort and coordination of benefits with other drug plans is not permitted. This means that the New Brunswick Drug Plan will only consider coverage for drugs listed on the New Brunswick Drug Plans Formulary when those drugs are not listed on the private plan formulary for the prescribed condition (indication) or are no longer covered because a private plan annual or lifetime maximum has been reached.
The New Brunswick Drug Plan is available to uninsured New Brunswick residents who have an active NB Medicare card. Information on obtaining NB Medicare coverage is available online.
Your NB Medicare coverage will only begin the first day of the third month after you have established permanent residence in New Brunswick. If possible, you may wish to obtain a 90-day supply of your medications before moving in case there are delays in receiving new drug coverage.
Once you have received your NB Medicare card, complete and submit the required New Brunswick Drug Plan application form.
No, those covered by the NBPDP do not need to join the New Brunswick Drug Plan. The NBPDP is a government-funded program that provides drug coverage to eligible beneficiaries, including seniors who receive the Guaranteed Income Supplement, nursing home residents, Department of Social Development clients, and others with certain medical conditions.
The New Brunswick Drug Plan is a prescription drug plan that provides drug coverage for uninsured New Brunswickers.
The New Brunswick Drug Plan offers coverage regardless of pre-existing conditions.
No. However, your spouse’s information is required on the application form even if your spouse is not applying for coverage. In the case of a couple (with or without children) in which only one spouse is requesting coverage, the premiums and maximum copayments are calculated based on the annual family income.
Eligible dependants include:
- all dependent children under the age of 19
- all dependants age 19 or older who are eligible for a Disability Tax Credit under the federal Income Tax Act, AND were eligible for the tax credit as a minor, AND reside with the applicant.
New Brunswick laws recognize that people who have reached the age of 16 are able to make independent decisions about how their personal health information is collected and used. As a result, dependants of applicants, who are 16 to 18 years old, must provide consent to share their personal health information with the New Brunswick Drug Plan by signing Section 5 of the application form. When a dependant of a member reaches the age of 16, the Plan sends a letter and consent form that must be completed and returned to the Plan.
If your family circumstances have changed you must notify the New Brunswick Drug Plan. To add or remove family members to the plan, please complete and submit the following form:
If there are changes to your personal or payment information, please complete and submit the following form and required document:
If it is within 14 days of the effective date of your coverage, you may withdraw your application by mailing, faxing, or calling the New Brunswick Drug Plan. No premium will be charged if no drug claims have been paid.
You may cancel your membership at any time by mailing, faxing, or calling the New Brunswick Drug Plan.
You may have to pay a re-instatement fee if you reapply for the New Brunswick Drug Plan within a year of the cancellation.
Yes, members enrolled in the New Brunswick Drug Plan who have other drug coverage are required to submit a new letter from their private plan every year. The letter must confirm that the drug covered by the New Brunswick Drug Plan is not listed on their private plan formulary for the prescribed condition (indication), or they have reached their private plan’s maximum annual or lifetime drug coverage. If the required documentation is not received, coverage is cancelled.
Yes, if a member has been approved for coverage under the New Brunswick Drug Plan because they have reached their private plan’s maximum annual drug coverage, their coverage will be cancelled when their private plan maximum resets. The member must re-apply to the New Brunswick Drug Plan each year when they reach their private plan’s maximum annual drug coverage.
Yes. When your private drug coverage changes (e.g. you obtain drug coverage with a new drug plan), you must complete and submit a new Supporting Application Form – Other Drug Coverage and provide a letter from your new private plan confirming that:
- the drug you have been prescribed is not listed on the private plan formulary for the prescribed condition (indication), or
- you have reached the private plan’s maximum annual or lifetime drug coverage.
No. The plan only covers approved drugs that are listed on the New Brunswick Drug Plans Formulary . No drug plan in Canada covers every drug on the market.
The drugs listed as benefits in the New Brunswick Drug Plans Formulary are determined through an evidenced-based review process which is used by federal, provincial and territorial drug plans.
Yes. The New Brunswick Drug Plan covers thousands of drugs, including some very expensive drugs. The drugs covered under the New Brunswick Drug Plan are listed on the New Brunswick Drug Plans Formulary. Certain drugs require special authorization and have specific criteria that must be met prior to being approved for coverage.
No. When generic products are available for a brand name drug, the New Brunswick Drug Plan will only reimburse pharmacies for the lowest cost generic product. Members who choose to receive a brand name product when a generic product exists are responsible for paying any difference in price.
The New Brunswick Drug Plan will consider requests for reimbursement of brand name drugs when a member has had a hypersensitivity reaction (e.g., edema, respiratory distress, serum sickness, anaphylaxis) to a non-medicinal ingredient contained in the generic product. Requests may be made by submitting a completed Special Authorization Request Form and providing details of the hypersensitivity reaction.
Information on the safety and effectiveness of generic drugs is available on Health Canada’s website.
The New Brunswick Drug Plan covers drugs listed on the New Brunswick Drug Plans Formulary which covers more than 5,000 drugs including many high cost drugs. The plan will cover approved drugs which have undergone a national evidenced-based drug review process currently used by public drug plans across Canada. Drugs are added to the Formulary following the same standard process.
Requests for drugs not listed on the Formulary may be considered in exceptional circumstances; however, the drug requested must be authorized for sale and used by Health Canada.
The New Brunswick Drug Plan covers prescription drugs only. Vaccines, medical devices, supplies and equipment (e.g. diabetic supplies, ostomy supplies, oxygen) are not eligible benefits under the New Brunswick Drug Plans Formulary. Some private insurers offer extended health benefits that cover these products.
No, these products are not eligible benefits under the New Brunswick Drug Plans Formulary.
The drugs covered under the plan are determined through a national evidenced-based Drug Review Process. They must first be approved by Health Canada, which issues a Notice of Compliance (NOC) and/or a Drug Identification Number (DIN) to the product, if the drug’s safety efficacy is established by scientific evidence. Health Canada has determined that while there are some potential benefits, current scientific evidence does not establish the safety and efficacy of cannabis to the extent required by the Food and Drug Regulations for marketed drugs in Canada.
For more information on cannabis for medical purposes, please consult Health Canada’s website at: https://www.canada.ca/en/health-canada/topics/cannabis-for-medical-purposes.html
All adult plan members pay monthly premiums to be part of the plan. Children 18 and younger do not pay premiums but a parent/guardian must be enrolled in the plan. All plan members must pay a 30% copayment up to a maximum amount per prescription. The premiums and maximum copayments are available online.
The premiums and maximum copayments are based on the family income, as indicated by the Canada Revenue Agency (CRA) tax return for the tax year immediately preceding the current tax year. Consent is required from each adult applicant to verify income with the Canada Revenue Agency. If consent is not received, the maximum annual premium will be charged.
Premium payment is due on or before the first day of every month in which the member is entitled to benefits. Your monthly premiums will be automatically deducted from your bank account each month. Depending on your financial institution, the payment may be withdrawn before or after the first day.
Because the premiums are based on ability to pay, members who are in a family will have their premium determined based on their family income. If only one adult enrolls in the plan, then only one premium must be paid. If two adults in the family enroll in the plan, then two premiums of the same amount must be paid. Children 18 and younger will not pay premiums, but at least one parent must enroll and pay a premium for one or more children to be covered.
Income means the total income as declared on line 15000 of your Income Tax Return, less any elected split-pension amount on line 11600 (if applicable). The CRA determines which sources of income must be included in the amount reported on line 15000.
Premiums and maximum copayments are reassessed annually (every summer), based on the family income, as indicated on the Canada Revenue Agency tax return for the year immediately preceding the current year. This annual reassessment ensures that members are paying the appropriate premium and copayment amounts.
You may request a reassessment of your income at any time, except during the annual reassessment period from August 1st to October 31st.
The NB Drug Plan does not refund or charge members for differences between monthly premiums before or after unscheduled (in year) reassessments.
If an applicant or their spouse does not file a tax return, the maximum annual premium will be charged. It is important to file a tax return each year so that your premium corresponds to your income. Premiums and maximum copayments are based on the annual family income, as indicated by the Canada Revenue Agency tax return for the year immediately preceding the current year.
New Brunswick Drug Plan premiums and copayments are considered eligible medical expenses and can be claimed on line 33099 or line 33199 of Schedule 1, Federal Tax, of your income tax return. For further information, please contact the CRA at 1-800-959-8281. More information is available online.
Tax receipts for the previous year will be mailed by the New Brunswick Drug Plan before the end of February.
The New Brunswick Drug Plan is reviewed annually to determine if adjustments to the premiums, copayments and/or income levels are required to account for factors such as prescription drug costs and inflation.
The annual review and adjustments help keep the Plan affordable for members while safeguarding its long-term sustainability. Any changes are effective November 1st.
If your premium payment is not received in full each month, your prescription drug claims will not be paid and your coverage will be suspended or cancelled.
If your coverage is suspended, you will not receive drug benefits until your account is paid in full. This means your prescription drugs will not be paid at the pharmacy. An official notice of suspension will be sent in the mail.
You will have 30 days from the date your coverage is suspended to pay the amount owing. If after 30 days, payment has not been received, your coverage will be cancelled.
You and your spouse will still be responsible to pay the amount owing, and collection efforts will be made to recover these overdue premiums.
If your coverage is cancelled, you will not receive drug benefits (your prescription drugs will not be paid at the pharmacy). You and your spouse are still required to pay the outstanding amount owing, and collection efforts will be made to recover these amounts. Failure to pay amounts owing could have escalating legal consequences.
Members who have had their accounts cancelled due to non-payment of premiums may be subject to a re-instatement fee and waiting period should they choose to re-enroll in the New Brunswick Drug Plan later.
You can pay your overdue premiums by sending a cheque or money order to the address below. Please include your New Brunswick Drug Plan ID Number with your payment.
New Brunswick Drug Plan
PO Box 690
Moncton, NB E1C 8M7
Overdue premium payments can be made online by following these instructions:
- Go to your financial institution’s website.
- Go to the Pay a Bill page.
- Select Medavie Blue Cross – Individual as the payee. Enter your 9-digit Identification number (located on your card) in the Account number field.
- Submit the payment by following your financial institution’s instructions. If you are unsure how to use your online banking, please contact your financial institution.
You must complete an application form to re-enroll;
- You may have to pay a re-instatement fee; and
- A three-month waiting period may apply before your coverage is effective.
Pharmacies that have registered with the New Brunswick Drug Plan as a participating provider can submit claims online to the Plan for payment. All plan members must pay a 30% copayment up to a maximum amount per prescription.
If a pharmacy has not registered as a participating provider, it cannot submit claims online to the Plan. A member may choose to fill a prescription at a non-participating provider; however, they will be required to pay the pharmacy for the total cost of the prescription and submit the official receipt to the Plan for reimbursement at the address below. Please note that a non-participating provider may charge a member a higher amount for a prescription than the Plan will reimburse.
No. The drug plans are for New Brunswick residents only. Once you permanently leave New Brunswick, your drugs are no longer covered.
You must advise the New Brunswick Drug Plan and New Brunswick Medicare of your moving date. Information on notifying NB Medicare is available online.
If you leave New Brunswick for elsewhere in Canada, you will still be covered by NB Medicare for three months, including the month you moved. If possible, you may wish to obtain a 90-day supply of your medications before moving in case there are delays in receiving new drug coverage.
New Brunswick Drug Plan
PO Box 690
Moncton, NB E1C 8M7
Telephone Number: 1-800-332-3692
Email: [email protected]