Form
Family Health Benefit Application Form
Complete this form to apply for the Family Health Benefit Drug Program.
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Form
High Cost Drug Program Application Form
Complete this form if you need assistance paying for expensive medications. You may be eligible for coverage of approved medication costs through the High Cost Drug Program.
Form
Erythropoietin Program Approval Form
Complete this form if you have been diagnosed with chronic renal failure, or are receiving kidney dialysis. You may be eligible for coverage of anemia treatment medications, which will eliminate the need for frequent blood transfusions.
Form
Home Oxygen Program Application Form
Complete this form if you have been diagnosed with Chronic Obstructive Pulmonary Disease (COPD) and have been prescribed oxygen. You may be eligible for coverage of expenses through the Home Oxygen Program.
Information
Hepatitis Drug Program
If you have been diagnosed with hepatitis or have been in close contact with someone who has hepatitis, you may be eligible for coverage of approved medication costs through the Hepatitis Drug Program. Am I eligible? You are eligible for this program if you are a PEI resident as...