Group Insurance Benefits Information

February 14, 2012

This is a reminder that drugs/health products available over the counter are NOT COVERED by our Extended Health Care Plans. This includes products that have been reclassified by Health Canada that now have a Natural Product Number (NPN) and drugs that have a Drug Identification Number (DIN) but you can buy off the shelf without a prescription. Drugs that have a Drug Identification Number (DIN) AND are only available with a medical practitioner’s written prescription are the only eligible drugs under the plan.

There are a few specific exceptions noted below related to serious medical conditions. Are there any drugs/products covered by our plan that a pharmacy or store can normally sell without requiring a written prescription but will be covered if prescribed by your doctor? YES. The following items are covered when prescribed by a doctor even though a pharmacy or other type of store may sell the product without a prescription:

  • For individuals diagnosed with diabetes – insulin, test tapes, needles and related supplies
  • For individuals with pernicious anemia – injectable liver extract or vitamin B12
  • For individuals with other severe medical conditions – oxygen and nitroglycerine

What over-the-counter products are ineligible?

Generally, any product with a DIN or NPN that you can buy over the counter without a prescription, is not covered by our plan even if it is prescribed by a doctor.
In order to save yourself unnecessary expenses, make sure that both your doctor and pharmacist understand that your plan does not cover over-the-counter drugs. If you are in doubt as to whether or not a product is available without a prescription, ask your doctor or pharmacist prior to getting the prescription filled. Frequently, your doctor may give you a note with instructions on how to take the medication as opposed to writing anything on their prescription pad. Don’t be afraid to ask you pharmacist if you can purchase it off the shelf. This way you will avoid unnecessary dispensing fees added to the cost of product, both of which you will have to pay out of your own pocket.