What the HLTH 349 is for
HLTH 349 registers a patient for the BC Palliative Care Benefits program. Plan P covers 100% of the eligible cost of prescription and over-the-counter medications on the Plan P formulary, up to PharmaCare’s maximums. The same form triggers an assessment by the local home and community care office for palliative supplies and equipment.
Eligibility has four criteria: a life-threatening illness or condition, a life expectancy of up to six months, consent to a palliative focus rather than treatment toward a cure, and a wish to receive palliative care at home. Home means wherever the patient lives, including with family, in assisted living, or in a residential facility bed not covered under Plan B. Patients in acute care aren’t covered.
Who completes it
A medical or nurse practitioner completes Steps 1 to 5 and signs to certify eligibility. The patient signs the consent in Step 6. If the patient can’t sign, their legal representative signs, or the practitioner signs when there is no legal representative. The form asks you to have a care plan conversation with the patient and to point them to the Plan P information sheet in their language.
How to fill in the registration
Registration type and Step 1, patient information
Tick New patient, Reassessment (required after 12 months), or Cancellation. For a cancellation, complete only Steps 1 and 3. Enter the patient’s name, PHN, date of birth, phone and mailing address.
Step 2, general indicators of poor or deteriorating health
Check two or more of the SPICT general indicators, such as unplanned hospital admissions, poor or deteriorating performance status, dependence on others for care, a carer who needs more support, progressive weight loss, persistent symptoms despite optimal treatment, or a request for palliative care. One indicator isn’t enough.
Step 3, clinical indicators of life-limiting conditions
Check at least one clinical indicator under the relevant condition: cancer, dementia or frailty, heart or vascular disease, neurological disease, kidney disease, liver disease, respiratory disease or other conditions. Pick the items that match the chart, such as eGFR under 30 with deteriorating health, or long-term oxygen for persistent hypoxia.
Step 4, diagnosis certified
Write the primary diagnosis and check each of the four eligibility boxes. An unchecked box means the patient doesn’t meet the criteria as certified.
Step 5, practitioner information
Enter your name, mailing address, phone and fax, and tick medical practitioner (CPSID) or nurse practitioner (PharmaNet ID). Use your college ID, not your MSP billing number. Sign and date.
Common reasons it’s delayed
- Fewer than two general indicators, or no clinical indicator, checked.
- One of the four eligibility boxes left unchecked.
- An MSP number entered instead of the CPSID or PharmaNet ID.
- The patient consent unsigned, with no representative or practitioner signature in its place.
- The form faxed to PharmaCare but not to the home and community care office, so no equipment assessment happens.
- Faxing the same form more than once to a location.
Submitting and who pays
Fax pages 1 and 2 to two places: Health Insurance BC at 250-405-3587 for drug coverage, and the local home and community care office for the equipment assessment. HealthLink BC at 811 can give you that office’s fax number. To check whether a patient is already registered, call the Palliative Care Confirmation Line at 250-405-3612 with your college ID. Plan P covers the drug cost and a dispensing fee of up to $11, and the patient may pay any amount a pharmacy charges above those maximums.