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Drug Coverage For Seniors

We recently received an email from a reader who was concerned about the high cost of prescription medication for seniors.  He was under the impression that after the age of 65 all prescription medication was covered by provincial health care.  I have to admit that I also thought this until my mother informed me that she was paying over $400 a month for her medications.

I looked into the various provincial plans and found that, for the most part, seniors do have complete or partial drug coverage.  All the provinces have very different plans.  Details for your province can be found here.

Drug Coverage For Seniors: A Brief Overview

Manitoba is the only province that doesn’t have a dedicated seniors’ program.  Their Pharmacare program is based entirely on income (regardless of age).  The deductible is based on income multiplied by 2.73% to 6.17% with a minimum of $100 per year.

Nunavut and Yukon seniors receive full drug coverage with health care paying the full cost of approved drugs (usually the lowest price generics).  Otherwise, Saskatchewan is the least expensive with people over 65 paying just $15 per prescription.

Alberta seniors pay 30% of prescriptions up to a maximum of $25 each.  AlbertaBlue Crossalso administers North West Territories’ drug care but the age is reduced to 60 years.

BC, Ontario, Newfoundland & Labrador, Nova Scotia and Quebec plans are based on income with most having a $100 deductible and coverage after up to 6.17% of income is paid.

Quebec, Nova Scotia seniors pay an annual premium of up to $563 (subject to income).

Ontario, Yukon and PEI all have residency requirements.  Applicants must be physically present for 6 months plus 1 day each year and the province must be the primary place of residence.

Interestingly, in Quebec everyone must be covered by prescription drug insurance, with either a private or public plan.

In Quebec and Newfoundland & Labrador seniors are automatically registered when they start to receive GIS and OAS benefits.  In all other provinces you have to apply for coverage.

With all plans:

  • Seniors must be enrolled in the Provincial Health Care plan
  • Drugs must be on the province’s approved drug list (can vary between provinces)
  • Payment is made only on the lowest price generic drug if a generic is available
  • Usually do not pay the dispensing fee

You could also check out the various private health care plans to compare costs and benefits.  For example, FlexCare drug plans are available through the Canada Protection Plan website.

Don’t stop once you’ve established a great plan, as there are more alternatives to save on your prescription drugs.  A few of these alternatives may seem more obvious than others.  Arguably the easiest way to save is to ask for generic drugs, as they can cost nearly a quarter of the price as their name brand counterparts.  Another money saving alternative is to order your prescription drugs online through Canada.  This method not only saves you money, but also a trip to the drug store. As always, speak with your doctor before making any drastic changes to your prescription.

Your best bet is to keep your employee benefits.  Most companies with health and drug benefits for employees extend them to retirees at considerable savings.  Make sure you actually retire and don’t just quit or you’ll lose them.

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