Extended Health Care Related Claim Forms
Extended Health Care Benefit Details
Extended Health Care Prescription Drugs
You and your eligible dependents are covered for prescription drug charges as follows:
- Prescription drugs must be medically necessary and used to treat a bona fide, serious medical condition.
- Prescription drugs must be prescribed by a licensed physician (M.D.) or dentist or other professional authorized by provincial legislation to prescribe drugs, and dispensed by a registered pharmacist or licensed physician (M.D.) legally authorized to dispense such drugs.
- Prescription drugs must be approved for sale by the Canadian Government and must contain a Drug Identification Number (DIN).
- Prescriptions drugs are limited to a maximum of a 3 month supply at any one time.
- You and your eligible spouse will be provided a Prescription Drug Benefit Card that you must present to your pharmacist when purchasing your prescription drugs for you and your eligible dependents.
Once you satisfy the eligibility requirements, you and your eligible spouse will be provided with a Prescription Drug Benefit Card to be used as follows:
- For the purchase of all your eligible prescription drug expenses.
- It is critical that the Administrative Agent have complete, accurate and up-to-date information on you and your dependents.
- In the event your Prescription Drug Benefit Card does not work at the pharmacy due to incomplete information, please contact the Member Benefit Card Services Department at 416-240-2103.
- If you are not in benefit at the date of your prescription drug purchase, your Prescription Drug Benefit Card will not work and you will be required to purchase the medication directly at the pharmacy.
- Should your Prescription Drug Benefit Card not function at the pharmacy and you are in benefit, you may purchase the medication and submit the drug receipt along with a completed claim form for assessment to Member Benefit Card Services Department.
The prescription drug plan does not reimburse the following:
- Drugs that can be purchased as over the counter medication or without a prescription.
- Drugs that are associated with anti-smoking, dietary, anti-obesity, health foods, nutritional products, vitamins, supplements, homeopathic medications vaccinations, immunizations, injectibles, fertility, erectile dysfunction and inter-uterine devices (IUD).
- Drugs that are used for non-medically necessary purposes and provided directly by a physician or hospital.
- Many brand name drugs on the market have a generic equivalent. In Canada, a generic drug has the same active ingredients as the brand name drug.
- It is recommended that you ask your physician to prescribe a less expensive generic equivalent drug if one is available. This does not mean that your health care will be negatively impacted because in Canada the generic drug has the same active chemical ingredients as a brand name drug.
- Generic substitution is the substitution of a less expensive drug for the originally prescribed brand name drug. This can be done by the pharmacist without the consent of your physician and is the normal practice of many pharmacists for a limited number of drugs.
Please feel free to access the Local 183 Living Well Drug Library for general drug information. Please note: Not all drugs listed in the Local 183 Living Well Drug Library are eligible under the Local 183 Prescription Drug Benefit Plan. Please contact our Member Services Department at 416-240-7487 for more information.