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Features-NB Drug Plan

What does it means for New Brunswickers?

Before April 1, 2014, this is what was covered under the New Brunswick Provincial Health Insurance Plan.

- Click here:  Fact Sheet   *


Now, with the new NB Drug Plan, another option will be available other than individual & group insurance plan coverage.

What will it means?  Well, as per the information provided to the public up to now, there are 2 phases in the process of implementing this new plan.

- Phase 1:  Starting April 1, 2014

• Voluntary enrolment.

- Phase 2:  After April 1, 2105

• Mandatory. that all New Brunswickers to have coverage.

What are options of drug coverage in New-Brunswick?

As per the information provided for the new Insurance act; 

All New Brunswickers must be a member of a prescription drug plan with benefits that is 

comparable to the government-sponsored plan.  

Now, it is time to make sure you have all the facts to better understand your options, to make the best decision for you and your family!

We recommend that you talk to a Licensed Health Plan Specialist.

* Fact Sheet provided by Manulife Financial

Co-Payment

....Also known  as "Copay"

A fixed dollar amount you pay for certain types of care.

-       You might pay a $20 for a chiropractor’s visit and the insurance company will reimburse the rest.   Plans with higher premiums generally have lower copays, and vice versa. 

      Here is what you get with Blue Cross Insurance, and that is why in my professional opinion, they have the best offer on the Canadian market at this point, compared to Manulife and Sunlife.

   

     ** What does a $50 Maximum Co-payment Per Prescription mean....to a client...?

The drug module under the Options and Options Plus personal health plans can help keep your costs down. It has no overall maximum and a maximum co-payment of $50 per prescription. The most you’ll ever pay for any one prescription is $50.

For example:

The $50 maximum co-payment per prescription could save you more than $3,500 in one year alone over a conventional 20% co-payment plan.  Overall, the Options Plus plan could save you more than $20,000 in one year.

Example of James (one of our client) living with Psoriatic arthritis:

Cost of medication:"Enbrel" 

• $1,733.69 (per month)
• $20,804.28 (per year)

Cost to James with 20% co-payment:

• $346.74 (per month)
• $4,160.86 (per year)

Cost to James with an Options or Options Plus plan: 

• only $50 per month = $600 per year.

So on a regular individual or group coverage, it could of cost James over $20,000 compared to $600.

Drug Expenses: Out-of-pocket

Your “out-of-pocket” expenses

Understanding Cost sharing: 

The terms “cost-sharing” or “out-of-pocket costs” refer to the proportion of your medical bills you will be responsible for paying when you actually receive Health Care Insurance.  Keep in mind, that Cost sharing never includes your monthly premium.

These are the four cost-sharing terms you will see.

Copay

A fixed dollar amount you pay for certain types of care.

-       You might pay a $20 for a chiropractor’s visit and the insurance company will reimburse the rest.

-       Plans with higher premiums generally have lower copays, and vice versa.

Coinsurance

A percentage of the cost of your medical care.

-       For glasses that cost $500, you might pay 20 percent ($100). Your insurance company will pay the other 80 percent ($400).

-       Plans with higher premiums generally reimburse a larger portion of the bill.

Out-of-pocket limit

• The most cost-sharing you will ever have to pay in a year.  It is the total of your deductible, copays, and coinsurance (but does not include your premiums). 
• Once you hit this limit, the insurance company will pick up 100 percent of your costs for the remainder of the year.
•   Plans with higher premiums generally have lower out-of-pocket limits.

NOTE: Most people rarely pay enough cost-sharing to hit the out-of-pocket limit but it can happen if you require a lot of costly treatment for a serious accident or illness.

Plan with Deductible

The amount you pay every year before the insurance company starts paying its share of the costs.

-       If the deductible is $2,000, then you would pay cash for the first $2,000 in health care you receive each year, after which the insurance company would start paying its share.

-       Plans with higher premiums have lower deductibles, and vice versa.

Make the right choice!  Ask for a no obligation Blue Cross quote!

Drug Cost...Nothing matters more than your health!

Cancer Drugs

Cancer Drug Statistics

Some truth about Cancer drugs in Canada

Lots of clients when we discuss about Drug coverage for cancer treatment, ask us:  Well, isn't that covered by our medicare...?

The sad truth; Not always.  

Unless you know someone close that went thru treatment, you might not realize that lots of drugs are not covered by medicare.

Their next question: Who pays for those Drugs...?

YOU DO!  Either from a personal drug plan, a group drug plan or from your own out-of-pocket.

Not to scare, but this is the reality we leave in.   With Medicare, we are covered when we are in hospitals, but we need to make sure we have our family well insured.

Here are a few facts:

• About 50% of newer cancer drugs are taken at home and, as a result, in most provinces patients can be responsible for the full cost[1]. 

• The average cost of a single course of treatment with newer cancer drugs cost $65,000[2].

• Of the 12 cancer drugs approved by Health Canada between 2000 and 2009 that are administered outside a hospital or clinic, ¾ cost over $20,000 or more annually[3]. 

---

[1] Backgrounder: Cancer Drug Access.  Canadian Cancer Society.  29 Sep 2010.  http://www.cancer.ca/Canada-wide/About%20us/Media%20centre/CW-Media%20releases/CW-2010/Backgrounder%20Cancer%20Drug%20Access.aspx?sc_lang=EN

[2] Majority of Canadians Worried About Cost of Cancer Drugs.  Canadian Cancer Society press release, Sep 29, 2010. http://www.cancer.ca/Canada-wide/About%20us/Media%20centre/CW-Media%20releases/CW-2010/Majority%20of%20Canadians%20Worried%20about%20Cost%20of%20Cancer%20Drugs.aspx?sc_lang=EN

[3] Cancer Drug Access for Canadians.  Canadian Cancer Society. September 2009.  http://www.cancer.ca/canada-wide/about%20us/media%20centre/cw-media%20releases/cw-2009/~/media/CCS/Canada%20wide/Files%20List/English%20files%20heading/pdf%20not%20in%20publications%20section/CANCER%20DRUG%20ACCESS%20FINAL%20-%20English.ashx

Drug & Health Insurance

Who needs Personal Drug & Health Insurance Plan?

The short answer – we all do.

While our provincial health care coverage ensures we have access to primary areas of medical care, Individual Health Insurance fills in the gaps of the cost of health care. 

Drug Plan includes coverage for prescription drugs.  Health Plan includes medical equipment, some services from registered professionals like physiotherapists or psychologists, vision care, dental care, and more.

Personal Individual coverage is designed for those who don’t have access to a group health care plan, most commonly those who are self-employed or between jobs.

By having your own personal plan, you are guaranteeing your coverage, in most cases, for life.

Ask #Questions, Get #Options, Make a #Choice!

If you are looking for a free quote, from plans that qualify for the new Drug Legislation in NB....Click here 

Blue Cross Options Plus