Drug coverage details
Your drug benefits
Your drug plan covers drugs which legally require a prescription from a physician or dentist which are dispensed by a pharmacist or physician.
Note: If you are a Quebec resident over age 65, or if you are a surviving dependant of a Quebec resident over age 65, please refer to your benefits booklet to learn more about your drug coverage and RAMQ legistlation.
How much do you have to pay?
Co-insurance:
Your co-insurance is 80%.
Please note that if you elect to purchase a brand name drug(s), reimbursement will be based on the lower
price if a generic drug(s) are available.
Your drug plan does not contain an individual nor family deductible.
Dispensing fee for formulary drugs:
Your plan covers pharmacy dispensing fees for formulary drugs up to a maximum of $8.00.
| If your dispensing fee is | Then you pay |
|---|---|
more than this maximum | the portion of the fee that is greater than the maximum |
equal to or less than the maximum | no dispensing fee |
Dispensing fee for non-formulary drugs:
Your plan covers pharmacy dispensing fees for non-formulary drugs up to a maximum of $8.00.
| If your dispensing fee is | Then you pay |
|---|---|
more than this maximum | the portion of the fee that is greater than the maximum |
equal to or less than the maximum | you do not pay the dispensing fee |
Dispensing fee for over-the-counter drugs:
Your plan covers pharmacy dispensing fees for over-the-counter drugs up to a maximum of $8.00.
| If your dispensing fee is | Then you pay |
|---|---|
more than the maximum | the portion of the fee that is greater than the maximum |
equal to or less than the maximum | no dispensing fee |
Limitation:
Your plan limits the supply of the following drug types:
| Drug Category | Limitations |
|---|---|
|
Fertility drugs |
Refer to the claim submission guidelines for information about completing and submitting the required pre-determination information for this benefit. |
|
Anorexiants |
No coverage |
|
IUD |
No coverage |
|
Diaphragm |
No coverage |