Out of Province Drug Subsidization coverage under the Newfoundland and Labrador Prescription Drug Program (NLPDP) extends coverage to beneficiaries who hold a valid NLPDP card and have been referred out of province for medical treatment. Beneficiaries may have the cost of their outpatient medications covered provided the medications are identified and authorized by this Department. Out of Province Drug Subsidization coverage is managed by the Assessment Office.
To obtain authorization for payment of out of province claims the department will require confirmation of the referral out of province for medical reasons by a physician of this province.
Arrangements should then be made, preferably with the Hospital Pharmacy to which the beneficiary was referred, to provide the following information:
It is in the best interest of the beneficiary, if the Department can be provided with a list of medications which may be required before and after the medical procedure/treatment. The list can be reviewed by Pharmaceutical Services noting the medications requiring special authorization or those that are not benefits of the program. When prior approval is requested, the beneficiary can be provided with special authorization forms should any of these medications be necessary. This will avoid delays in coverage for the beneficiary.
NLPDP does not provide coverage for cancer chemotherapy and anti-rejection medications. There is an interprovincial agreement in place where there is coverage of these medications. A resident of Newfoundland and Labrador, in receipt of a valid Medical Care Plan (MCP) card, will be provided the necessary medications for in-hospital chemotherapy (cancer only) and anti-rejection therapy (transplant). The hospital will invoice the host jurisdiction’s Ministry of Health which will in turn bill the Newfoundland and Labrador Department of Health and Community Services. The medications provided under this agreement are:
Exception to the Out of Province Drug Subsidization policy is considered for beneficiaries who, while out of province for travel or non-medical purposes, experience a medical emergency requiring hospitalization and new medications. In order to obtain a reimbursement for the new medications, the beneficiary must submit the following:
Medical emergencies considered for reimbursement under the NLPDP include but are not limited to: