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BC PharmaCare Increasing the Reimbursement Amount for Prosthetics

Victoria – People in British Columbia will have better access to life-changing prosthetics and orthotics as BC PharmaCare increases the reimbursement amount for eligible devices.

“Prosthetic and orthotic devices help improve people’s health and quality of life,” said Adrian Dix, Minister of Health. “Increasing government’s share of the reimbursement cost – in some cases, even doubling it – will mean it will be more affordable for British Columbians to get these devices and enjoy their many health benefits.”  

As of Friday, Oct. 8, 2021, BC PharmaCare is increasing the reimbursement amount for:

  • prosthetics for arms and legs;
  • orthotics for children and youth; and
  • non-limb prosthetics, such as eyes, ears and noses.

The increased reimbursement amount will close the gap between BC PharmaCare’s maximum reimbursement amounts and a provider’s fees, making the devices more affordable. It will also benefit providers who may otherwise incur losses when patients are unable to afford the cost.

BC PharmaCare covers labour and material costs for manufacturing and dispensing custom prosthetics and orthotics, based on the recipient’s PharmaCare plan. Prosthetists and orthotists must be enrolled in PharmaCare as device providers to submit claims on behalf of their patients.

The new schedule, which is based on the Prosthetic and Orthotic Association of British Columbia’s fee guidelines, is expected to benefit more than 2,500 people in B.C. each year and cost BC PharmaCare $5 million over two years. This is the first change to the schedule since 2010.

This reimbursement increase is one more way BC PharmaCare helps people in B.C. access the medical devices and prescription drugs they need. In January 2019, B.C. made a $105-million investment over three years to reduce or eliminate Fair PharmaCare deductibles and co-payments for lower-income British Columbians. Starting Jan. 1, 2020, government eliminated Medical Services Plan premiums, giving more money back to British Columbians.

FYI:

To learn more about BC PharmaCare, visit: www.gov.bc.ca/pharmacare

To learn more about prosthetics and orthotics, visit: www.gov.bc.ca/pharmacare/medicalsupplies

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