OPERATION MAYHEM
Operation Mayhem was a term we came up with to describe our incredibly crazy plan to try to get all of our patients in Warman, Martensville, and surrounding area to fill out the SK drug plan (it is explained a couple paragraphs below). Then, Operation Mayhem II was the idea that we could get every one of our seniors to fill out the Special Support Plan to use as a supplement to the seniors plan. Well, well, well, we never expected the population to grow to approximately 10,000 in both Warman and Martensville. There were other complications as well, such as filling out the forms for people who couldn't, finding tax returns, or contacting the children of the seniors who were in charge of the taxes to get the required information, etc etc. We didn't hit our goal, but we did a heck of a lot of work in trying.
Today, I want to discuss insurance, and more particularly, SK Insurance under the SPDP (Saskatchewan Provincial Drug Plan- Odd that they needed the provincial part after they said Saskatchewan; can we say redundant? :D )
Currently, the SK gov health insurance covers meds without a premium to the user for kids 14 and under (anything on formulary and over $25), covers all 3 levels of social services (varying co-pay) and covers seniors (NOT ALL) for medication (on formulary) that is over $25. Seniors who earn more than $66,500/ year do not qualify!!! Crazy, I know, but it is what it is. The SPDP also has an insurance available to everyone, that is income based. It's called the Special Support Program. Trust me, that is very very misleading.
For close to 30 years, the special support program has been available. When it was formed, and to this day, they didn't really want people to use it, and I can defend that argument by the following: 1) It's called the Special Support Program- nobody wants to sign up for something that's called a special support program; you know it and I know it, so the government at the time of inception damn well knew it. 2) In all the years I studied at the University of Saskatchewan, I never once saw an advertisement promoting the program, it's uses, it's potential benefits, etc. Every year they always said 'we have allocated 'x' amount to medication expenses; 'allocated' being the operative word there, but never said how to make it available. 3) In all the years practicing in SK, I have never seen the SPDP do an academic detail to docs, pharmacists, or nurses on the program. We still don't know all the nuances, and have to phone in, BUT, props to the actual fantastic women who work there; they will tell us anything we want to know.
The SPDP plan will pay for medication (based on a % and varying levels) based on income. 3.4% of your income is the threshold for some coverage. This may seem like a lot, and it is (and they sure as hell didn't come up with that number arbitrarily, I can tell you that), but medication can get there very quickly. As a matter of fact, MOST PRIVATE INSURERS are requiring people to apply for the SPDP Special Support Program regardless of whether they will qualify or not!!!! [Legends Pharmacy] staff have made up a list of how to go about that when your private plan is asking for enrolment in the provincial plan. Just ask one of us at the Rx pick up queue. So, fill it out anyway. It's only once per lifetime, you will never have to do it again, it will end up helping (maybe not now, but one day) and it will prevent your private insurance from suspending your benefits, and trust me, they will. We have had people where it has taken a year to get their plan back on after having it suspended for non-provincial enrolment.
For SENIORS and those whose PARENTS ARE SENIORS- The special support plan can be used in conjunction with the seniors plan!!!!!!! Very important, and something most people do not know (not even people in the health care business). If you are a senior, or you have parents, in-laws, etc that are seniors, let them know they have a good shot at decreasing their monthly medication costs. Just have the contact us if they need to.
Maybe I should have a short coffee and snack information session about this at the pharmacy or rec centre? We would like to get all of our seniors and anyone else to apply for the program anyway. In our opinion, it is a good move to do now, and not later. What do you think?
Glenn Murray, August 2013
edited by Deven Johnson, October 2018