Prescription Drug Benefits
Research shows that 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.
Solutions That Fit Your Needs
- Drug plans are a main factor in plan member satisfaction
- Optional drug card plans provide immediate reimbursement
- Innovative plan design options to help manage costs
Plan Design Options
You can 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 or Provincial Drug 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:
- Provides coverage for drugs that have been prescribed by a doctor
- Includes drugs that require a prescription, and some over-the-counter drugs
Find out more about how we can help you manage drug plans.
Claims Payment Options
You choose the method of claims payment your plan members use for their drug purchases.
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.
Reimbursement – a traditional payment option where plan members pay for their prescriptions at the time of purchase and submit their claims online through Great-West’s GroupNet For Plan Members or on paper for reimbursement.
Deferred reimbursement drug card (Assure CardTM) –
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.
A note to plan sponsors in Quebec
The Quebec government has a public drug plan that covers anyone who is not eligible for coverage under a private plan. This plan is administered by the Régie de l’Assurance Maladie du Québec (RAMQ).
The law in Quebec also requires private drug plans to provide equivalent or better coverage than the public plan. Plan sponsors in Quebec are limited in how much they can alter their drug coverage, since they must ensure it conforms to RAMQ.