Who pays first: the province or your employee benefit plan?

July 18, 2018

Extended health-care benefits help plan members and their families pay for medically necessary expenses that are not covered by the provincial plan. If there is government coverage available for a prescription drug, medical service, or supply that is also eligible under the Employee Benefit Plans, the government plan must always pay its portion first.

Common coverage from the provincial government includes:

Saskatchewan Special Support Program (SSP)

This government program is in place to help families with high drug costs in relation to their income. Once Great-West Life has paid $1,000 in drugs for your family, they will send you a letter directing you to apply for SSP coverage. You must send the confirmation of your SSP coverage to Great-West Life. If you do not apply to SSP, then your drug coverage will be suspended until you do.

Seniors’ Drug Plan (SDP)

Eligible seniors 65 years and older pay a maximum of $25 per prescription for prescription drugs listed on the Saskatchewan drug formulary. Eligibility is determined by age and the income reported on your income tax return. Great-West Life will send you a letter six months before you turn 65 directing you to apply to SDP. You must send the confirmation to Great-West Life. If you do not apply to SDP, then your drug coverage will be suspended until you do.

Saskatchewan Aids to Independent Living (SAIL)

Training
A continuous positive airway pressure machine.

This program covers a variety of medical supplies including some mobility aids and prosthetics.

Most recently, costs associated with renting continuous positive airway pressure (CPAP) machines are now covered by the SAIL Respiratory Equipment Program. Patients now have access to the ongoing loan of a CPAP machine for a fee of $275. If you submit an estimate for a CPAP machine, Great-West Life will direct you to apply to SAIL. If you have purchased a CPAP and were not aware of the new government coverage, Great-West Life will allow the claim on a first time forgiveness basis until December 31, 2018.


No Very





Captcha Image