Enhanced Prescription Drug Benefit

Requiring medication to treat a serious medical condition is stressful, without the additional worry of whether you can afford to pay for it. New medications are constantly being introduced, and these – like many prescription drugs – are often costly and not covered by government health plans. This can leave you suddenly faced with unmanageable drug expenses.

The Enhanced Prescription Drug Benefit covers you for large, unexpected prescription drug expenses in addition to any drug coverage provided under your chosen PlanDirect plan (Basic, Comprehensive or Premier plans include drug coverage).

Prescription drug claims are submitted under your selected PlanDirect plan first, until the plan maximum has been met. Once you have reached the maximum benefit amount under your selected plan, claims are then submitted under the Enhanced Prescription Drug Benefit.

Benefits payable under this option are reimbursed at 100% for eligible prescription drug expenses, up to $250,000 per insured family member per calendar year. The payment made under your selected PlanDirect plan is subtracted from your selected deductible (either $2,500 or $5,000), meaning you may not have to pay the full amount of the deductible.

The Enhanced Prescription Drug Benefit is only available with your initial PlanDirect purchase—you can’t add it later.

Termination age

The Enhanced Prescription Drug Benefit is only available before age 65. This option can remain in effect as long as your PlanDirect policy remains in force.

Exclusions

This coverage is not available to residents of Quebec.