Immigration, Refugees and Citizenship Canada has added Mifegymiso to their Prescription drug coverage.
Immigration, Refugees and Citizenship Canada (IRCC) administers the Interim Federal Health Program (IFHP). The program provides limited, temporary health coverage for protected persons, including resettled refugees, refugee claimants, and certain other groups who are not eligible for provincial or territorial health insurance. This includes coverage for most prescription medications and other products listed on provincial or territorial public drug plan formularies and is provided through Medavie Blue Cross.
IFHP provides basic coverage to eligible persons while they wait for the issuance of provincial/territorial health coverage (in general, resettled refugees are eligible for basic health coverage from province or territory of residence upon arrival in Canada, IFHP covers them in the interim and covers those who are not eligible for full coverage by provinces or territories, as well as some other eligible people).
For those who receive provincial or territorial coverage, once they receive health insurance from the province or territory they settle in, the IFHP continues to provide coverage for supplemental services, including dental and vision care and prescription drugs for up to one year. IFHP beneficiaries can visit any health care practitioner in Canada for covered services if the practitioner is already registered or willing to register with Medavie Blue Cross.
In 2017, Mifegymiso was made a part of the prescription drug coverage (similar to the coverage given to social assistance recipients by provincial and territorial governments). An issue is arising in provinces like Ontario which have implemented universal cost coverage for Mifegymiso but have not added it to the formulary (a prerequisite to access the medication through the prescription drug coverage of IFHP). In some instances, prescribers may be able to bill IFHP directly if they dispense the medication as oppose to send the client to the pharmacy to pick up their prescription.
Barriers to Access
We encourage the government to:
Many factors impact the health of newcomers to Canada as well as their access to health care. These include but are not limited to: precarious immigration status that prevents people from accessing public healthcare (including coverage by the IFHP in the first place), economic barriers, language barriers, racism and harmful assumptions as well as mental health issues exacerbated by migration and discrimination.
In June 2012, major cuts were made to the IFHP: services covered were narrowed and complex rules were implemented about which categories of refugees were entitled to which services. Many health care providers were reluctant to provide services covered by the IFHP because of the complicated bureaucracy. Some provincial governments stepped in to provide some of the services cut.
In July 2014, the Federal Court ruled that the cuts were a violation of the Canadian Charter of Rights and Freedoms. To comply with the court order, the federal government added some additional coverage in November 2014 for certain categories of refugees.
The new government elected in October 2015 restored the IFHP as it existed prior to the 2012 cuts. Although access to healthcare through the IFHP has been reinstated for most refugees and refugee claimants, there remains confusion about who is eligible and difficulties in processing claims under the IFHP have resulted in some healthcare providers turning away eligible patients and denying them care.
In provinces where workarounds are necessary, access to an essential medical service is dependent on finding service providers who have the infrastructure or partnerships necessary to dispense Mifegymiso. Considering the time-sensitive nature of medical abortion, this service should be listed under basic coverage as opposed to supplemental coverage.
1. Ensure the equitable, easy and timely access to a comprehensive package of reproductive and sexual health services (including medical abortion) for all people covered by the IFHP by listing medical abortion as part of the basic coverage package instead of listing Mifegymiso on the prescription drug coverage.
2. Actively address barriers to newcomers accessing health care in Canada, including measures and programs causing delays in coverage of health care services and goods.
3. Implement measures to encourage and support health care providers’ participation in the program.
4. Develop education pieces for health care providers on best practices for treating people covered by the IFHP.
5. Work with Medavie/Blue Cross to create a more streamlined way to make claims or educate health practitioners on this as well as ensure transparency and collaboration with practitioners and Medavie/Blue Cross.
6. Ensure pharmacies have the resources and training needed to provide, process and bill for prescribed medication covered by IFHP.
7. Fund Interpretation services and system navigation assistance programs, including peer navigator programs.