Nova Scotia PHARMACARE - Update in 2 Parts

PART 2: GOVERNMENT RETRACTS PROPOSED PHARMACARE PREMIUM INCREASE - FEBRUARY 18, 2016

The Nova Scotia Government has backed off implementing the proposed changes for premium increases. Under public pressure the Government is speaking a different language about another review and consultations with seniors.

Although this may be seen as a short term reprieve the Government has already let it be known there is a financing problem they need to get control of.

My feeling is the Government will do its superficial meeting process, reassure it's voters and come back well before any election with another premium increase proposal. A proposal that will be less offensive.

Our article below has many valuable tips you need to seriously consider when selecting a Private Drug Plan. Reasonable premiums, more than twice as many drugs covered (10,000 vs. 5,000 in NS Pharmacare) and also the need to have a full health care plan.

Remember, NS Pharmacare is a DRUG Plan ONLY.

Please contact us for a quote on Blue Cross premiums and see what a great alternative this can be for you.

If you are 50 or over then ask about Assured Access a product designed to provide you the ability to freeze any pre-existing health condition now and protect your access to a full Health and DRUG When 'you ' decide to retire. It's an outstanding product.

We are here for your health, drug, life insurance and investment needs.

PART 1: ORIGINAL POST - GOVERNMENT PROPOSES HUGE INCREASE IN PHARMACARE PREMIUMS - FEBRUARY 11, 2016

Nova Scotia has just released its new rules governing Pharmacare -

EFFECTIVE DATE is APRIL 1, 2016.

What is Nova Scotia PHARMACARE for Seniors?

It is a DRUG ONLY Plan and does not include all Drugs. It is NOT a Health Plan.

  • Pharmacare is a DRUGS ONLY Plan. It DOES NOT cover: Glasses, Physio, Chiro, Medical Equipment, Hospital semi-private rooms, Ambulance, Travel, etc.

  • PRIVATE HEALTH CARE Plans can include: Drugs, Health, Travel, AD&D, etc. even Dental (although my experience says retirees don't want the dental and would rather self insure that part).

NOTE: Private plans have a PRE-EXISTING Health Condition EXCLUSION. So if you are currently on numerous drugs then NS Pharmacare may still be your best option. It will be important for you to do a financial comparison so you know you have selected the best Option for you. PREMIUMS: (NS Pharmacare) SEE PART 2 ABOVE

  • The ANNUAL premiums under the plan have increased from $424 per person to a maximum of $1,200 per person, a maximum increase of 180%.

  • It's $2,400 per senior couple up from $848 per year, a maximum increase of 180%.

  • For Single Seniors if you make more than $33,500 you will be paying more under the New RULES.

  • For Senior Couples if you make more than $38,500 you will be paying more under the New RULES.

The new NS Pharmacare Pricing model looks like this:

Premiums for single seniors:

  • Income below $22,986: will not pay any premium

  • Earning $22,986 to $35,000: less than $40/month

  • Earning $35,000 to $75,000: $40 to $100/month, based on income

  • Earning more than $75,000: $100/month

Premiums for senior couples:

  • Combined income below $26,817: will not pay any premium

  • Combined income of $26,817 to $40,000: less than $40/month each

  • Combined income of $40,000 to $100,000: $40 to $100/month each,

  • Combined income above $100,000: $100 /month each

To know exactly what PREMIUM you would have to pay you have to go online to: http://novascotia.ca/dhw/pharmacare/seniors-pharmacare.asp or call them directly at 902-429-6565.

Co-PAY:

EVERYONE who joins NS Pharmacare is ALSO required to pay the Co-pay percentage of 20% up to the maximum $382 in Co-pay payments per person.

What is Co-pay?

  • It is your share of drug costs with the Province picking up the other 80%.

  • When your maximum combined Co-pay amounts total $382 per person the Province will pay 100% of future 'Eligible' Drug purchases for that person. Notice I mention 'ELIGIBLE' Drugs.

  • The co-pay percentage has dropped from 30% to 20% which sounds good but the total drugs required to max out that co-pay amount has gone from about $1,300 at 30% to about $1,900 at 20% essentially a 50% increase.

DRUGS COVERED:

  • The NS Pharmacare Drug Formulary (their list of Eligible Drugs) covers approximately 5,000 drugs (DINs = Drug Identification Numbers) while a Blue Cross Enhanced Plan covers approximately 10,000 drugs (DINs).

  • Canada's Provincial Pharmacare plans take 468 days on average to list the new drugs they have decided to cover in their respective Provincial plan Formularies.

  • Private Drug plans take an average of 132 days to add drugs to their lists.

NOTE: You can go the Provincial website and search for which drugs are eligible under their plan.

REFERENCE: This data was taken from a report by an independent think tank, the Canadian Health Policy Institute.

There is a huge difference between the number of drugs covered in many Private Plans vs. Public Plans. It's important that you understand this as your decision to join either plan is a long term commitment.

QUESTION: SHOULD YOU JOIN the NS Pharmacare Program? What should you do?

OPTIONS:

  • Join the plan

  • Join a PRIVATE HEALTH CARE PLAN

  • Do NOT join either NS Pharmacare OR a Private Plan.

You are NOT obligated to join NS Pharmacare at 65 BUT you must understand the options and consequences.

What happens if I don't join at 65 but decide to join later?

You can join later.

  • IF you had a Private Plan from 65 onwards then you'll need a letter from the insurance company proving you were covered the whole time.

  • You will need to prove you were actually in a Private Plan and if so then you will eligible to pay the regular annual Pharmacare Premium.

  • IF you opted to NOT join a private health care DRUG plan then you will be allowed to join Pharmacare later but with a 50% premium penalty for five (5) years. If you are at the maximum income level that would mean either $1,800 per year (instead of $1,200) for a SINGLE or $3,600 per year (instead of $2,400) for a COUPLE.

I can only assume the reason for the penalty is to encourage, if not require, as many people as possible to join the plan. The more people joining the more money the government will have.

Those people who aren't using many, if any, drugs at age 65 probably feel they couldn't rationalize / justify the NS Pharmacare Premium.

The Government doesn't want people only joining the plan when their personal drug costs skyrocket just because they have now have some new and expensive illness. So they want to ensure people are covered somewhere, hence the penalty if they don't join either Pharmacare or alternatively have a PRIVATE Plan.

CAN I LEAVE THE NS PHARMACARE Plan if I am a current member?

YES you can.

A simple phone call or letter will accomplish this.

I would be careful and would only encourage this if you have REVIEWED and SELECTED a PRIVATE Plan as the better financial alternative for your hard earned money.

ALTERNATIVES: (We've used the Couple Example below)

If you were a couple paying or thinking about paying $2,400 a year for the NEW NS Pharmacare's 20 % co-pay plan then you could buy one of the following Blue Cross ALTERNATIVES:

With PRIVATE PLANS you normally need to have a HEALTH Component as well as a DRUG component.

  1. A Blue Cross Drug Plan with a 20% co-pay for $138 per month PLUS their BEST Health Plan (includes Travel) for an additional $135 per month for Monthly total of $273 per month. For people who travel this is an excellent option which includes 30 day trip coverage for as many individual trips you want in a year.

  2. A Blue Cross Drug Plan with a 20% co-pay for $138 per month PLUS a Mid range Health Plan for an additional $64 per month for Monthly total of $202 per month.

  3. Chose the 30% co-pay Blue Cross Drug plan at $119 per month PLUS their MID range Health plan at $64 a month. Your total would be $183 per month. The number of Drugs covered by this 30% co-pay plan is similar to NS Pharmacare.

  4. A 30% Co-pay Blue Cross Drug plan at $119 PLUS their BASIC Health plan at $45per month for a total of $163 per month. The number of Drugs covered by this 30% co-pay plan is similar to NS Pharmacare.

UNDER 65:

FOR THOSE NOT yet 65 but want a private plan when you retire, contact us so we can explain the benefits of a product called ASSURED ACCESS.

You remain in your Company's Health plan until you retire BUT we underwrite you today which essentially freezes your medical conditions from an underwriting perspective.

Any new illnesses between now and when you retire will be covered fully in your private plan when the full plan is activated.

ASK us about this great product that costs about $1 per day for a couple.

It's a great total health protector product.

WRAP-UP:

As the Province of NS tries to control its costs and has just substantially increased premiums in the NS Pharmacare Plan don't forget about the Great Private Plan ALTERNATIVES we offer. Better health is not always just about DRUGS.

We sell Blue Cross but wanted you to see what the benefits could be for you.

Please contact us for more information and details on each of these alternatives.

We encourage you to share this with family & friends so they too can pass this along to others who could benefit from this information.


Recent Posts
Archive
  • LinkedIn App Icon