The premiums and maximum copayments are calculated based on the annual family income, as indicated by Canada Revenue Agency tax return for the year immediately preceding the current year. All adult plan members pay monthly premiums to be part of the plan. Children 18 and younger will not pay premiums but a parent must be enroled in the plan. All plan members must pay a 30% copayment up to a maximum amount per prescription.
Premiums and copayments (effective April 1, 2015) are as follows:
| Gross Income Levels | Premiums | Copayments | ||
| Individual | Individual with children / Couple with or without children | Annual Premium (per adult) |
Monthly Premium (per adult) |
30% Copay to a Maximum per Prescription |
| $17,884 or less | $26,826 or less | $ 200 | $ 16.67 | $5 |
| $17,885 to $22,346 | $26,827 to $33,519 | $ 400 | $ 33.33 | $10 |
| $22,347 to $26,360 | $33,520 to $49,389 | $ 800 | $ 66.67 | $15 |
| $26,361 to $50,000 | $49,390 to $75,000 | $1,400 | $ 116.67 | $20 |
| $50,001 to $75,000 | $75,001 to $100,000 | $1,600 | $ 133.33 | $25 |
| More than $75,000 | More than $100,000 | $2,000 | $ 166.67 | $30 |