Your two options for paying for prescription drugs

November 17, 2020

options

The Extended Health Care Plan is unique in the way it provides two options to plan members making prescription drug claims. One option is to pay with the “pay direct drug card.” The second is paying out of pocket and submitting a claim.

Your prescription needs and your payment preferences determine which option is right for you. You have the flexibility to change your payment preference each time you visit the pharmacy. 

The pay direct drug card

The plan offers a convenient pay direct drug card that provides instant payment at the pharmacy, less a $10 per prescription deductible.

When plan members use the pay direct drug card, it helps to avoid out-of-pocket costs and there are no claim forms to complete.The claim process is complete when you leave the pharmacy. 

Paying out-of-pocket and submitting a claim

The plan also offers a reimbursement option. You may pay the full amount of your prescription at the pharmacy, submit your claims for reimbursement, and pay a $9 per family per day prescription deductible.

For plan members using the manual reimbursement method, you receive a higher level of reimbursement when you purchase all of your and your family’s prescriptions on the same day.

Example:

A plan member purchases five different prescriptions on the same day.

Using the pay direct drug card, they would pay a $50 deductible ($10 per medication) and pay for any medication costs that the plan does not cover.

If that same plan member submits a paper or electronic claim, they would pay the full cost of the five prescriptions at the time of purchase. They would then submit a claim form with receipt(s) to Canada Life. The plan member would then be reimbursed the full amount covered by the plan less the $9 deductible per family per day.

Lost or stolen drug card?

You can download a temporary card directly from GroupNet for Plan Members. You can also contact 3sHealth and we will request a new card for you.


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