There are many medications used in the treatment of cystic fibrosis so it is understandable that the cost can be an issue. Even with government funding and insurance coverage, sometimes we are not able to get the medications we need.
Find out the common cost and coverage issues related to cystic fibrosis medications and what your health care team, social worker, and pharmacist can do behind the scenes.
CF Drug Coverage
If you are currently a non-Ontario resident who is relocating to Ontario, or moving for your CF care and/or lung transplant, there are a couple of things to consider when it comes to drug coverage.
First, when an individual moves from one Canadian province to Ontario, there is a three-month waiting period before he or she can become eligible for coverage in Ontario. During this time, the individual is covered by the provincial plan of your home province. You should make an application for Ontario coverage and an OHIP number immediately upon your arrival to Ontario. Also, consider which maintenance medications you will need and have your current CF team order you enough medication for at least a 3 month period. You can then bring that medication with you to Ontario or have it mailed to you from your pharmacy in your home province.
Second, it is common that new medications may need to be started during your three-month waiting period. Some have reciprocal billing such that your medications will be covered by the Ontario Drug Benefit program which will bill your home province for you. Other provinces require that before you leave your home province, you must receive a letter from the Ministry of Health that you are to submit to the pharmacy each time you pay for medication. This arrangement requires you to pay for medications up front, and then your home province will reimburse you on a monthly or quarterly basis, all depending on the arrangement they make with you. Before you move, please inquire with your home province which arrangement exists, and let our team know on your first visit.
For more information, please speak to your physician, pharmacist, or social worker.