Using examples, we illustrate how you can reduce the portion you pay for the cost of a medication. Remember that drug plan reimburses 80% of the cost of your prescription drugs (prescribed by a doctor). Following the submission (online or by post) of your complaint, you will receive reimbursement of 80% of the price you paid in pharmacies. The 20% not refunded are therefore assumed by you.
How to Reduce This 20% You Have to Assume?
The price of a drug is made up in part of the fees added by a pharmacist for his professional act. These fees vary from pharmacy and are billed for having prepared your prescription according to the rules. These fees are now clearly presented on the official receipt. Indeed, the famous fees will be lower, all things considered, than if you take only a simple amount of the same medicine at online pharmacy.
- Price of the drug for 1 month: $74,16
- Price of the drug for 2 months: $ 129,90 (rather than 2x$74,16 = $148,32)
You save $18,42
You will have understood that, if you have to take a medication in good quantity or for an extended period, it is cheaper for you to stock it up for more than a month at a time!
- Price of medication for treatment: $26,76
- Price of the drug for three treatments: $ 40,03 (rather than 3x$26,76 = $80,28)
You save $40,25
So, even if your prescriptions are reimbursed at 80%, by buying in large quantities, the balance you assume at online pharmacies could be reduced appreciably. Naturally, the savings vary depending on the drug and the fees set by your pharmacist.
Personal Economy Means Collective Economy
By saving individually on the cost of your medications, you are helping to keep the group plan more generous for all members. By reducing the cost of your bill at online pharmacy, 80% reimbursed by the insurance plan is also reduced. By the same token, this directly contributes to lowering the expenses of the plan which, for its part, is supported by all the members, including you. We mistakenly think that it is the insurer who pays for the reimbursement of medicines.
If you have to take medication for a fairly long period of time, you may want to stock up on more at once. Instead of a month of medication, ask for two or three months.
Online Medication Claims
To claim reimbursement online of your medication from the insurer, you must first create your group insurance file by registering on the following site of your insurer:
- Click on ‘Connect’
- In the new window, choose ‘Individuals’, then ‘Group insurance’.
- Then, in the new window opened, on the right: ‘Register now’.
- Follow the instructions with your certificate number and the contract number.
- To make a claim, use the ‘Make a claim online’ tab at the top.
- It is necessary to register your pharmacy as a supplier before any request.
- Complete the refund request using the data from the relevant receipt.
Of course, you keep your receipts which may be required from time to time – by mail – for checking purposes, which is perfectly normal.
Your personal group insurance file allows you to print the annual register of all your claims. This allows you to see how much you have been reimbursed, and how much you have personally assumed. This document can be used to establish your tax deduction (for your taxes) as medical expenses. Several expenses are eligible including the deductible – precisely the 20% non-reimbursed of your medication.
Generic Drugs at Online Canadian Pharmacies
If your insurance protection includes drug coverage, you may want to develop a simple reflex: whenever a doctor prescribes a drug for you, or whenever you go on the pharmacy website to get a prescription drug, ask an online specialist for a generic.
What is the generic?
All drugs are laboratory inventions that are protected by a patent (a kind of copyright). These patents allow the laboratories in question to distribute what is called a brand name drug exclusively. This right grants the laboratory the exclusivity of this original drug in a given territory, for a fixed period. After this period, all laboratories have the right to copy the recipe for the medicine and sell it (under another name). As the research and development costs were borne by the original laboratory, the copied version can be sold for less.
This copy of the medication is called a generic medication. This drug is said to be as effective. Its great interest is its frankly lower cost (up to 60% cheaper!). The important thing is to make an informed choice in all circumstances.
The rules for dispensing original drugs, or originators, sometimes preferred to generics thanks to the mention “NS” or “non-substitutable” on a prescription have been tightened. The dispensing of a generic drug therefore becomes systematic, with a few exceptions. A decision that angered many health professionals.
Online and offline pharmacies have the right to give a generic medicine in place of the one prescribed on the prescription provided that this medicine is in the same generic group and that a doctor has not excluded this possibility by affixing the handwritten words “non-substitutable” on the prescription. Doctors cannot add this mention to their prescription without justifying a medical reason that meets the criteria.
The latter lists three medical situations allowing doctors to annotate the term “non-substitutable”. Drugs with a narrow therapeutic margin relate to few drugs. These include Levothyrox or medicines to avoid rejection after a transplant. The second case, is that of generic drugs that are not pediatric (and therefore unsuitable for a child). You have to imagine an original drug available in syrup form but which, in generic terms, would only be in tablet form. Currently, this scenario does not exist, they necessarily have the same form, so it is a situation that may exist in the future. Another case is the most complex, it concerns proven allergies to excipients with known effects, according to a list defined by the health authorities, which we are still in the process of establishing but which concerns very few medicines.
However, if online pharmacies still have to offer generics, a patient has the right to take reference medicine if he wants. He will then no longer be able to claim third-party payment. However, from now on, the reimbursement of an insured person who does not wish, without medical justification, the substitution proposed by the pharmacist will be made now on the basis of the price of the generic. Generic costs on average 40-60% less than the original product.
Non-substitution is a situation that may also be necessary depending on the patient’s state of compliance and on the dosage of the drug. The government has been trying for several years to increase the use of generic drugs in order to save money in the health sector. There was launched an information campaign on the subject in order to dissipate the mistrust of the Canadians, generally reluctant to ask for generics.
The generic substitution rate to date exceeds 80% in Canada, but the mechanisms in favor of substitution show today a certain breathlessness. There is a considerable delay in the use of generic medicines in Canada, despite of the effectiveness and the absence of side-effects of these drugs.