Ostomy Supply Reimbursement in Prince Edward Island

The Ostomy Supplies Program assists with the costs associated with a permanent ostomy.

Eligibility

You may be eligible for the program if you:
Types of Ostomies Covered:

How To Apply For Benefits

  • Health care professional ( NSWOC, NP or Physician) submits a Health Care Provider Ostomy Supplies Program Registration Form on the patient’s behalf.
  • The patient must also complete and submit an Ostomy Supplies Program Patient Application Form which is required to verify income with the Canada Revenue Agency.
  • Coverage is not retroactive, and you will not be reimbursed for ostomy supplies you purchased before the program enrolment approval date.
  • Your eligibility for this program will end when you leave PEI to take up residency elsewhere.

Benefit Coverage

Depending on household income, you may be eligible for up to 100 percent coverage to assist with the out-of-pocket cost of eligible ostomy supplies to a maximum of $2,400 per full program year from July 1-June 30. If you apply past July 1, your eligible amount will be pro-rated to reflect the percentage of time remaining until June 30.

What Products Are Covered?

  • Skin wafers
  • Ostomy pouches
  • Adhesive removers
  • Skin barrier wipes
  • Stoma powders, pastes and barrier rings
  • Ostomy belts

Annual Household Income

Eligible Coverage

$0 – $20,000
100%
$20,001 – $40,000
95%
$40,001 – $50,000
90%
$50,001 – $100,000
70%
$100,001 or greater
60%

Benefit Coverage

Depending on household income, you may be eligible for up to 100 percent coverage to assist with the out-of-pocket cost of eligible ostomy supplies to a maximum of $2,400 per full program year from July 1-June 30. If you apply past July 1, your eligible amount will be pro-rated to reflect the percentage of time remaining until June 30.

Annual Household Income

$0 – $20,000

Eligible Coverage

100%

Annual Household Income

$20,001 – $40,000

Eligible Coverage

95%

Annual Household Income

$40,001 – $50,000

Eligible Coverage

90%

Annual Household Income

$50,001 – $100,000

Eligible Coverage

70%

Annual Household Income

$100,001 or greater

Eligible Coverage

60%

What Products Are Covered?

  • Skin wafers
  • Ostomy pouches
  • Adhesive removers
  • Skin barrier wipes
  • Stoma powders, pastes and barrier rings
  • Ostomy belts

Reimbursement Procedure

You must pay for your supplies at your local pharmacy/home health centre and request a detailed invoice listing all supplies purchased.

All claims must include an Ostomy Supplies Claim Submission Form.

  • If you have private insurance, you can submit a detailed invoice for your supplies along with your insurer statement showing the remaining out-of-pocket expense.
  • If you do not have private insurance, you can submit a detailed invoice for your supplies.

You may submit your invoices and Ostomy Supplies Claim Submission Form monthly or every two to three months. Invoices older than six months will not be eligible.

You must purchase eligible ostomy supplies in Canada.

Non-ProfitAssistance in PRINCE EDWARD ISLAND

The Prince Edward Island Cancer Society will cover up to the full costs for new ostomates, provided the patient has a firm cancer diagnosis. This support will be limited to no longer than two years and is available to only 24 individuals for any given year. Please see the following link for more details on the Canadian Cancer Society: http://www.cancer.ca/

Contact Information:

PRINCE EDWARD ISLAND PHARMACARE

16 Fitzroy Street, Sullivan Building
Charlottetown PEI C1A 7N8

Telephone: (902) 368-4947
Toll-free: 1-877-577-3737

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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