Palliative care benefits program
The BC Palliative Care Benefits Program allows patients to receive palliative care at home rather than be admitted to hospital. The program gives palliative patients access to the same drug benefits they would receive as if in hospital, and access to some medical supplies and equipment from their health authority.
The Pharmaceutical Services and Health Authorities Divisions of the Ministry of Health and palliative care physicians would like referring physicians to know that:
• Patients who have not yet reached the end stage of a life-threatening illness are eligible for other coverage under Pharmacare plans including Fair Pharmacare.
• The BC Palliative Care Benefits Program supports BC residents of any age who have reached the end stage of a life-threatening illness and who want to receive medically appropriate palliative care at home (defined as wherever the person is living, whether in his or her own home, with family or friends, or in a supportive or assisted-living residence or hospice that is not a licensed residential care facility covered under Pharmacare Plan B).
• Support from the BC Palliative Care Benefits Program includes full coverage of approved medications (Pharmacare Plan P) and equipment and supplies (upon referral to, and assessment by, Home Health).
• Eligible patients are those who have up to 6 months’ life expectancy and, usually, a Palliative Performance Scale (PPS) of 50% or less if—after discussion of the prognosis—both the patient and physician agree that the focus of care is palliative.
• In some circumstances, patients with a PPS score of over 50% will qualify for Plan P when they have a life expectancy of less than 6 months and if—after discussion of the prognosis—both the patient and physician agree that the focus of care is palliative.
• If a patient has a PPS score of over 50% and is still receiving BC palliative care benefits after 12 months, the Ministry of Health may ask the physician to re-verify the patient’s eligibility.
• Patients should register for BC’s Fair PharmaCare plan at www.health.gov.bc.ca/pharmacare/fpcreg.html if they have not already done so. Fair Pharmacare covers Pharmacare benefits not included in Plan P.
• For patients who do not meet the criteria for Plan P, coverage options through other government insurers (such as Veterans Affairs Canada) and private insurers can also be considered.
