Income Reviews and Family Changes

If your family circumstances change, we may be able to adjust your Fair PharmaCare assistance. Here are some of the circumstances that may warrant increased assistance.

Decrease in income of 10% or more during the past two years

We normally base your Fair PharmaCare coverage on your income information from two years ago. Our income review process ensures that families who experience hardship because of a decrease in income can access increased Fair PharmaCare coverage. Regardless of the reason for the drop in income (e.g., a change in your employment status, recent retirement, etc.), if you meet the requirements, your level of coverage can be increased immediately.

Important: You can apply for an income review only for the current year and must submit your application before December 31. You cannot apply for a review for a previous year.

To be eligible for an income review:

  • Your family's net income must have decreased by 10% or more from the amount used to calculate your current level of coverage, and
  • You will need to provide acceptable documentation to support your income information.

To estimate if you are eligible for an income review, see page 2 of the Income Review Application(PDF).

Divorce or separation/child custody

If you and your spouse separate or divorce, both you and your spouse should contact us. We will arrange for your Fair PharmaCare family membership to reflect your current situation. If you and/or your former spouse experience a drop in income as a result of the change in your marital status, increased assistance may also be available.

It is also important that your children be included in the family of the appropriate parent (a child cannot be included in more than one family).

Note: If your family membership with the BC Medical Services Plan (MSP) changes, we will normally notify you by letter, asking you to clarify your information. It is important to respond to this letter promptly to prevent termination of your Fair PharmaCare coverage.

Spouse who is now living in a residential care facility

If your spouse has recently moved to a residential care facility and you are experiencing difficulty with the cost of your prescriptions, contact the Medical Services Plan (MSP) and enquire about being "deemed separate." This will enable us to exclude your spouse's income when calculating your Fair PharmaCare coverage.

If Medical Services Plan (MSP) does not approve you request, contact us. If subtracting your spouse's residential care fees from the combined income of yourself and your spouse results in an amount lower $33,000, you are eligible for increased Fair PharmaCare assistance.

Death of a spouse

Your spouse's income is included in the calculation of your Fair PharmaCare coverage until the end of the year. This allows your spouse's prescription costs to count towards your deductible.

However, if having your spouse's income included creates financial difficulty and your income has decreased by 10% or more in the past two years, you can request that your coverage be based on more recent income information by applying for an Income Review.

For more information, please read Decrease in income of 10% or more during the past two years.

How do I apply?

Complete the Income Review Application (PDF). Before sending in your application, contact us at the phone numbers provided on the back of the application form. Our staff will advise you of the specific supporting documents you should include with your application to confirm your decreased income.

Send your completed application form and your supporting documents to:

Health Insurance BC
Attention: Fair PharmaCare
PO Box 9685 Stn Prov Govt
Victoria BCV8W 9P2
Or Fax it to (250) 405-3598

We will review your application and, where possible, verify your income with the Canada Revenue Agency (CRA). If your application is approved, we will advise you of your new level of coverage—usually within one month of receipt of your application.

Has more than a month has passed since you applied? You can check the status of your application. Contact Health Insurance BC between 8:00 AM and 4:30 PM, Monday to Friday.

Note: If the income information you provide with your application cannot be verified when tax information for that year becomes available, PharmaCare will recover any overpayment of assistance.

Is there a deadline for applying for increased assistance?

Yes. You must apply before December 31 of the year for which you want increased coverage.

What will my family's deductible be based on while our income review is being processed?

Your deductible will not change until the income review is approved.

If my family is assigned a lower deductible, will this deductible be applied retroactively? Will I be reimbursed for amounts paid over and above the lower deductible?

Yes. If your income review results in a lower deductible and family maximum, it applies to the eligible cost of any prescriptions you purchased after the later of:

  • January 1, or
  • the date your family registered for Fair PharmaCare, or
  • the date of the most recent addition or removal of a spouse from your family Fair PharmaCare record, or
  • the date your income-based Fair PharmaCare coverage was reinstated*.

* Your coverage may have ended and then been reinstated if you did not return the consent form authorizing PharmaCare to verify your income with the Canada Revenue Agency, did not file a tax return, or if you resided outside B.C. temporarily.

If you qualify for a refund, you will be reimbursed automatically in the spring of the following year.