Ostomy Supply Reimbursement In Newfoundland and Labrador

The Ostomy Subsidy Program

The Newfoundland and Labrador Prescription Drug Program (NLPDP) provides financial assistance to purchase eligible prescription medications for those who reside in the province. There are five main plans under the program: The Foundation Plan, The 65Plus Plan, The Access Plan, The Assurance Plan and The Select Needs Plan. The Ostomy Subsidy Program is only offered to the 65 Plus Plan and Foundation Plan.

Am I Eligible?

NLPDP may provide funding for ostomy supplies for clients:

Have the following plans:

65 Plus Plan:
residents 65 years of age and older are automatically enrolled in this program if they receive the Old Age Security Benefits (OAS) and Guaranteed Income Supplement (GIS).

The Foundation Plan:

Persons and families in receipt of Income Support benefits through the Department of Advanced Education, Skills, and Labour,
Children in the care of the Regional Health Authorities or the Department of Children, Seniors and Social Development, as the case may be,
Individuals involved with Community Youth Corrections,
Persons in receipt of community supports, and
Subsidized residents in Long Term Care Homes and Personal Care Homes.

The NLPDP is the payor of last resort, which means they will only pay for ostomy supplies if you do not have third-party coverage.

Ostomy Supply Orders

Clients must purchase their ostomy supplies through third-party ostomy vendors such as pharmacies and home health care stores.

Benefits Coverage

100% for those in Foundation Plan
75% for Ostomy Subsidy program for people in 65 Plus plan
0% for those not enrolled in either plan
As of Nov. 2018, residents can apply to the Special Assistance Program, where coverage has client contribution is based on income & cost of supplies.

How to Apply for the 65 Plus Plan

There is no Program-specific application to be completed for coverage unless the Resident is a landed immigrant. Service Canada notifies the Program that a Resident receives the GIS and Old Age Security benefits, usually after receiving their first GIS payment. An eligibility letter is sent out to the Resident asking for their MCP number, date of birth, and gender to issue a Program drug card.

For more information: https://www.gov.nl.ca/hcs/files/prescription-provider-guide-program-plans.pdf

How to Apply for the Foundation Plan

There is no Program-specific application to be completed for coverage. A drug card is automatically issued when the Program is notified that a Resident receives one of the services noted previously.

Reimbursement Procedure (65 Plus Plan Only)

Before coverage authorization, the client must be enrolled in the Foundation Plan or 65 Plus Plan.

The 65Plus Plan will reimburse you for 75% of the retail cost of ostomy items. You are responsible for the remaining charges. You will need to purchase your ostomy supplies and submit the original prescription receipts to the Ostomy Subsidy Program for reimbursement. Be sure to note your Program Card Number. Beneficiaries of the 65Plus Plan also pay a professional (i.e. dispensing) fee to a maximum of $6.00.

You can claim the remaining charges as a Medical Expense on your income taxes.

Contact Information:

Ostomy Subsidy Program
Newfoundland and Labrador Prescription Drug Program

PO Box 8070 Postal Station A
St. John’s NL A1B 4A6

Phone: 709-753-3615

Disclaimer: The information contained in this page have been researched and sourced from a variety of provincial and federal sites. However information may change and we encourage individuals to check for updates of policies, plans and forms.

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