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  • Canada Hlth 5355 - British Columbia 2021

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And receive a Confirmation of Assistance letter? Is your net income for last year or this year at least 10% less than your income from two years ago? If you answered yes to these questions, use this form to apply for additional Fair PharmaCare assistance for this year. IMPORTANT: To request increased assistance for this year, submit your application and supporting documents no later than December 31. You cannot request more assistance for a previous year. Please read all information.

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How to fill out the Canada HLTH 5355 - British Columbia online

Filling out the Canada HLTH 5355 form is essential for individuals who wish to apply for increased Fair PharmaCare assistance based on their income review. This guide will provide you with a clear and supportive overview of each section of the form to ensure a smooth application process.

Follow the steps to complete your application effectively.

  1. Click the ‘Get Form’ button to obtain the form electronically and open it in your preferred editor.
  2. In the first section, enter your personal information, including your last name, first name, personal health number, street address and city, postal code. If applicable, also provide your spouse's last name, first name, and personal health number.
  3. Go to the 'Calculate your net income for Fair PharmaCare' section. Choose whether you are applying with last year's income or this year's income. Input the relevant amounts from the worksheet provided.
  4. Make sure to submit the worksheet along with supporting documents for both yourself and your spouse or partner. Check the instructions on page 2 for acceptable documents.
  5. In the declaration section, certify that the information you provided is true and complete. Sign and date the application. Ensure your spouse or partner also signs if applicable.
  6. Include all supporting documents as photocopies only, ensuring not to send the original documents. Review the checklist for required documents based on your income sources.
  7. Mail your completed application along with the supporting documents to Health Insurance BC at the address provided. Ensure it is sent before the deadline of December 31 for this year's assistance.
  8. After mailing the application, keep the copies of all documents for your records. You can expect to hear back from Health Insurance BC regarding your application status within a month.

Complete your application online today to ensure you have the assistance you need.

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