PEI Pharmacare is a family of drug programs, not one plan. The Generic Drug Program caps eligible generic drugs at $19.95 for uninsured Islanders under 65, and the Seniors' Drug Program covers approved medications at 65 and older.
Applies in: Prince Edward Island
PEI Pharmacare is not a single plan. It is a family of provincial drug programs, and you apply to the one that matches your situation. The Government of Prince Edward Island lists its drug programs together, including the Seniors' Drug Program for people 65 or older, the Generic Drug Program for uninsured Islanders under 65, and the Family Health Benefit Drug Program for low-income families with children.
Most programs share two starting points: you are a PEI resident as defined by the Drug Cost Assistance Act, and you hold a valid PEI Health Card. The drugs each program pays for are the ones identified on the PEI Pharmacare Formulary, and some of them require special authorization. This guide covers the application routes only and gives no advice on which program suits you.
Seniors' Drug Program. If you are age 65 or older, you are eligible for coverage of the cost of approved medications through this program. The province's program summary states that seniors pay the first $8.25 in medication cost and $7.69 of the dispensing fee, while the rest of the cost is covered.
Generic Drug Program. This program is for Islanders under the age of 65 who do not have insurance. It limits out-of-pocket costs for eligible generic prescription drugs to a maximum cost of $19.95. Diabetes drugs sit outside this cap because another program covers them, and controlled substances are also excluded.
Family Health Benefit Drug Program. If you are a low-income family, this program helps cover the cost of approved prescription medications for you and your children if they are under the age of 19, or under the age of 25 and a full-time student. The applicant must be an adult, age 18 or older, and that person receives all correspondence about the program.
Catastrophic Drug Program. If the cost of your prescription medication is making it hard to pay other essential life expenses, you may qualify for coverage of certain medications through this program.
High Cost Drug Program. If you need assistance paying for medications, you may be eligible for coverage of approved medication costs through this program. The province's program history names the kinds of drugs it has covered, including medications for cancer, multiple sclerosis, wet macular degeneration, rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, psoriatic arthritis and pulmonary hypertension.
Diabetes Drug Program. A program for diabetes medications and supplies. From May 1, 2025, many insulin products and oral diabetes medications are eligible for full coverage under the National Pharmacare Program instead.
Other named programs. The province also lists a Children in Care Drug Program for children under the care of the Director of Child Protection, a Financial Assistance Drug Program for people eligible for financial assistance under the Social Assistance Act and Regulations, a Nursing Home Drug Program for residents of private nursing homes, and an Institutional Pharmacy Program for residents of government long-term care nursing homes or manors. A travel supply policy lets clients enrolled in listed programs, including the National Pharmacare Program, the Seniors' Drug Program, the Diabetes Drug Program, the Generic Drug Program and the Catastrophic Drug Program, obtain up to 180 days of eligible medication before leaving the province. Narcotic, controlled and targeted medications are not eligible for travel supply.
This is the program with a full application route set out on its own page.
Step 1: Confirm the basics. You are a PEI resident as defined by the Drug Cost Assistance Act, you have a valid PEI Health Card, you have filed your most recent income tax return in PEI, and you are a low-income family supporting at least one child under 19, or under 25 and a full-time student.
Step 2: Complete the application form. Submit a completed Family Health Benefit Application form. First-time applicants send the form to PEI Pharmacare by fax, email or mail.
Step 3: Add proof of enrolment for a student dependant. If you are including a dependant between 19 and 25 who is a full-time student, proof of enrolment from the educational institution must accompany your application. For a re-application, that proof must reach PEI Pharmacare before approval.
Step 4: Note the coverage dates. If you are approved, coverage begins on the date in your approval letter and continues until September 30. You must re-apply each year before your coverage expires. Families already receiving benefits can re-apply online. Coverage ends when you no longer have children under 19, or under 25 who are full-time students.
Step 5: Use any pharmacy in the province. You can fill your prescription at any community retail pharmacy located in Prince Edward Island. Coverage is not retroactive: you will not be reimbursed for medications you bought before coverage began.
Contact for the program: PEI Pharmacare, 16 Fitzroy Street, Sullivan Building, Charlottetown, PE C1A 7N8. Telephone (902) 368-4947, toll free 1-877-577-3737.
The province states the eligibility list plainly. You are eligible if you have no private drug insurance coverage, are under 65 years of age, are a PEI resident as defined by the Drug Cost Assistance Act, have a valid PEI Health Card, and have completed an application and been approved for coverage. The $19.95 cap then applies to eligible generic prescription drugs you fill.
If you have private insurance and you are in the Family Health Benefit Drug Program, you or your pharmacy must submit all claims to your private insurer first. The remaining out-of-pocket eligible expense can then be submitted to PEI Pharmacare for assessment. Send claims in that order.
The official program pages opened for this guide state the program names, the $19.95 Generic Drug Program cap, the Seniors' Drug Program cost share of $8.25 plus $7.69, and the Family Health Benefit application route and September 30 coverage end. They do not state a full income table for the Family Health Benefit Drug Program on the pages read here beyond the low-income test itself, and they do not state a processing time for a first application, so this guide gives neither. They also do not state an application fee, so this guide does not describe applying as free or as paid.
| Generic Drug Program, Islanders under 65 with no insurance | Out-of-pocket cost for an eligible generic prescription drug capped at a maximum of $19.95 |
|---|---|
| Seniors' Drug Program, age 65 or older | Senior pays the first $8.25 of medication cost and $7.69 of the dispensing fee; the program covers the rest |
| Family Health Benefit Drug Program | Coverage runs to September 30 and you re-apply each year before it expires |
Most PEI Pharmacare programs ask for a PEI resident as defined by the Drug Cost Assistance Act and a valid PEI Health Card. Covered drugs are the ones on the PEI Pharmacare Formulary, and some need special authorization.
No. PEI Pharmacare is a set of drug programs run under the Drug Cost Assistance Act. They include the Family Health Benefit Drug Program, the Seniors' Drug Program, the Generic Drug Program, the Catastrophic Drug Program, the High Cost Drug Program, the Diabetes Drug Program, and several smaller programs for specific situations.
If you are 65 or older, a PEI resident as defined by the Drug Cost Assistance Act, and you hold a valid PEI Health Card, you are eligible for coverage of approved medications. Seniors pay the first $8.25 of medication cost and $7.69 of the dispensing fee, and the program covers the rest of the cost.
The Generic Drug Program is for Islanders under 65 who do not have insurance. It limits out-of-pocket costs for eligible generic prescription drugs to a maximum of $19.95. You need to have no private drug insurance, be a PEI resident, hold a valid PEI Health Card, and have completed an application and been approved.
Submit a completed Family Health Benefit Application form to PEI Pharmacare. If you are including a dependant under 25 who is a full-time student, proof of enrolment from the educational institution must go with the application. Coverage runs to September 30, and you re-apply each year before it expires. Families already in the program can re-apply online.
The program helps with approved prescription medications for you and your children if they are under 19, or under 25 and a full-time student. Coverage ends when you no longer have a child in one of those groups.
For the Family Health Benefit Drug Program, if you have private insurance you or your pharmacy submits claims to your private insurer first. The remaining out-of-pocket eligible expense can then be submitted to PEI Pharmacare for assessment. Coverage under PEI Pharmacare is not retroactive, so you are not reimbursed for medications you already bought before coverage started.