ARM Health Insurance – Frequently Asked QuestionsView questions by category:
If you don't see the answer to your question, please contact an OTIP life and living benefits sales representative at 1-800-267-6847. Prescription Drugs QuestionsWhat is the deductible?The deductible is the maximum amount you must pay out of your own pocket in addition to your plan premium before your prescription drugs become eligible for reimbursement.
If your drug plan carries a $25 deductible, this means you will be required to spend $25 of your own money on prescriptions before your drug expenses become eligible for reimbursement. Are dispensing fees covered?Dispensing fees are usually included in the total cost of purchasing drugs and are your responsibility under the ARM health plans. Charged by pharmacies to prepare your prescription, dispensing fees can range up to $12 per prescription. Some pharmacies have lower dispensing fees, so shop around to see where you can get the best rate.
Our mail-order pharmacies, Rexall Direct and Pharmex Direct, have lower dispensing fees and can be used to decrease your costs on maintenance drugs. When you use one of our mail-order pharmacies to fill your prescription, 90% of the ingredient costs are covered by the ARM health plans. Do I have to pay upfront for prescription drugs and wait for reimbursement?No – all ARM health plans provide you with a pay-direct drug plan. You will receive a benefits card that you can present to your pharmacist. The pharmacist will bill the Insurer electronically for their portion of the drug costs. You need only pay for your portion, the dispensing fee and any deductible that applies if you choose ARM Economy or ARM Original. What if I have high drug costs?Ontario's Trillium Drug Plan provides prescription drug coverage to individuals/families that have high drug costs in relation to their income and do not meet the eligibility criteria for the Ontario Drug Benefit Program.
View our information flyer on the Trillium Drug Program. Why do I need drug coverage over age 65?All ARM plans will pay for a portion of the $100 Ontario Drug Benefit (ODB) deductible charged to most Ontario residents under the ODB program. The ARM health plans pay for several hundred more prescription drugs that are not covered by the government formulary. |
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OSSTF 60 Mobile Drive, Toronto, ON M4A 2P3 1-800-267-7867 | www.osstf.on.ca
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