Prescription Drug Benefits
Research has shown plan members value having a drug plan as part of their benefits package. We offer a range of drug plan options that can be tailored to suit your organization's needs, allowing you to better manage your prescription drug benefits while still providing your plan members with coverage they value. Table Start
Solutions That Fit Your Needs
- Drug plans are a main factor in plan member satisfaction
- Optional drug card plans provide immediate reimbursement
- We offer solutions for managing costs
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Plan Design Options
You may choose from plan designs offering a range of coverage, including the following.
Managed drug plan:
- Provides coverage for a selective list of drugs through managed care formularies such as the Assure National Drug Plan listing, Provincial Drug Formularies or frozen formularies
- Covered drugs are chosen for their cost and therapeutic value
- New medications are not automatically covered by the drug plan
Prescription drug plan:
- Provides coverage for drugs that require a prescription for dispensing or for sale
- Includes some life-sustaining drugs which may be available without a prescription
- Excludes over-the-counter drugs
Comprehensive drug plan:
- Also provides coverage for drugs that have been prescribed by a doctor
- Includes drugs requiring a prescription, and some over-the-counter drugs
Find out more about how we can help you manage drug plans.
Claims Payment Options
You can choose the method of claims payment your plan members will use for their drug purchases.
Reimbursement – a traditional payment option where plan members pay for their prescriptions at the time of purchase and submit their claims on paper for later reimbursement.
Pay-Direct drug card (Assure CardTM) – on-the-spot claims processing of prescription drugs at almost any pharmacy in Canada. A plan member presents his or her Assure Card to the pharmacist, who submits the claim electronically. The plan member’s eligibility and drug coverage is confirmed and he or she pays only the portion not covered by the plan.
Deferred drug card (Assure CardTM) – similar on-the-spot processing of prescription drugs submitted electronically by the pharmacist at the point of sale. The plan member pays for his or her prescriptions and is reimbursed by cheque once a dollar-amount or time-period threshold is reached.
Find out more about The Assure Card™ drug card.
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