The maximum days’ supply for most prescriptions that can be reimbursed by the New Brunswick Prescription Drug Program (NBPDP) at a time is 100 days. Exceptions to this include benzodiazepines, narcotics, or controlled drugs which are limited to a maximum of 35 days’ supply, and Designated High Cost Drugs which are limited to a maximum days’ supply when administered at standard doses.
NBPDP beneficiaries who are leaving the province for more than 100 days may be eligible for reimbursement of a travel supply as long as the prescription allows.
Reimbursement
At the Pharmacy (NBPDP Seniors)
Claims for a travel supply of certain drugs for NBPDP beneficiaries who are seniors (Plan A) may be submitted electronically by pharmacies prior to the senior leaving the province. Claims must meet the following criteria:
- One travel supply of up to 100 days may be submitted in addition to a first fill/refill of up to 100 days. The total quantity of each drug that the senior has on hand cannot exceed a 200 day supply.
- The senior should be stabilized on his/her drugs.
- The senior must provide the following travel details to the pharmacy which must be retained on file and be readily available for audit purposes:
- A letter, which can be written by the senior themselves, confirming that they are leaving the province for more than 100 days and specifies the departure and return date
or
- A copy of their travel insurance, confirming that they are leaving the province for more than 100 days.
By Mail (All NBPDP Beneficiaries)
NBPDP beneficiaries may purchase a travel supply of drugs prior to leaving the province and submit the receipt for reimbursement of eligible drugs after returning to the province. Reimbursement can only be considered once at least 80% of the days’ supply of the previous prescription has elapsed. The following documentation must be sent to NBPDP at the address below:
- An official prescription receipt from the pharmacy.
- Travel details:
- A letter, which can be written by the senior themselves, confirming that they are leaving the province for more than 100 days and specifies the departure and return date
or
- A copy of their travel insurance, confirming that they are leaving the province for more than 100 days.
Note: The reimbursement amount for the drug cost, pharmacy dispensing fee and mark-up will not exceed the regulated rates that were in effect on the date of the receipt. Pharmacies may not charge NBPDP beneficiaries more than regulated rates for the drug cost, pharmacy dispensing fee and mark-up, even though they pay out-of-pocket for the prescription.
Designated High Cost Drugs
Certain designated high cost drugs are limited to a maximum days’ supply and are listed on the Manufacturer List Price (MLP) List and Maximum Allowable Price (MAP) List.
Travel supplies of these drugs may not be submitted electronically by pharmacies. NBPDP beneficiaries may purchase a travel supply of drugs and submit the receipt for reimbursement of eligible drugs after returning to the province. Reimbursement can only be considered once at least 80% of the days’ supply of the previous prescription has elapsed. The following documentation must be sent to NBPDP at the address below:
- An official prescription receipt from the pharmacy.
- Travel details:
- A letter, which can be written by the senior themselves, confirming that they are leaving the province for more than 100 days and specifies the departure and return date
or
- A copy of their travel insurance, confirming that they are leaving the province for more than 100 days.
Benzodiazepines, narcotics and controlled drugs
Prescriptions for these drugs are limited to a maximum of 35 days’ supply at a time.
Pharmacy Claim Submissions
Claims for travel supplies for seniors (Plan A) prior to their departure must be submitted as follows:
First fill/refill: The pharmacy must submit the initial claim electronically for up to a maximum of 100 days’ supply, depending on the drug.
Travel supply: The pharmacy must submit the travel supply claim electronically on the following day, using the CPhA Intervention Code MV for up to a maximum of 100 days’ supply. The total days supply on hand cannot exceed 200 days.
Mailing Address
New Brunswick Prescription Drug Program
P. O. Box 690
Moncton, NB E1C 8M7