Understanding your drug plan

Your drug plan pays for a portion or all of your prescription medication, and saves you money. To get the most out of this benefit, and prevent delays at the pharmacy it is important to learn about how your drug plan works.

Who is in charge of your drug plan?

The company where you or the card holder works hires an insurance company to manage the drug plan. Alternatively if you are a senior (over 65), or on social assistance , the provincial government manages the drug plan. To learn about the details of your plan contact your insurance company.

How do I ensure that the pharmacy will bill to my drug plan?

Show your personal drug plan card to a pharmacy staff member when you drop off your prescription. If you have a direct bill plan it will pay for your medication at the pharmacy.

If you have a reimbursement plan (instead of a direct bill plan) you will have to submit your receipts by mail so that the insurance company will pay their share. Your pharmacy will keep your drug plan information on file, so it is not necessary to show your drug plan card to your pharmacy every time you fill a prescription. However, if your plan changes you must provide the pharmacy with updated drug plan information.

How many days of my prescription can I fill at a time?

Each plan allows different amounts of medication to be filled at a time. Some plans allow 100 days while others only allow 30 days. Ask a member of the pharmacy team how many days your plan will allow.

Why are some prescriptions rejected by my drug plan?

Not all medications are covered by drug plans. Additionally, each drug plan is different in which medications they cover. For some there may be a less expensive medication that is covered that will work as well. Your pharmacist may be able to make a recommendation to your doctor for an alternative that would be covered.

Why do I have to pay for my prescription even though I have coverage?

Some drug plans require that you pay a portion of the prescription (co-pay). Other plans require that you pay a deductible every year. For example you must pay the first $200 of prescriptions before your coverage kicks in.

Why won’t my plan pay for my compounded prescription?

We can not bill compounded medication directly (except to Alberta Blue Cross and social services). You will have to submit your receipts by mail to receive reimbursement for any compounded medications.

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