Frequently Asked Questions - Retiree Health Insurance - Prescription Drugs
What 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 RTIP 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 RTIP plans.
Do I have to pay upfront for prescription drugs and wait for reimbursement?
No – all RTIP 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 RTIP Basic or RTIP Plus.
What if I have high drug costs?
Ontario's Trillium Drug Program 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 (PDF, 64 KB).
Why do I need drug coverage over age 65?
All RTIP plans will pay for a portion of the $100 Ontario Drug Benefit (ODB) deductible charged to most Ontario residents under the ODB Program. The RTIP plans pay for several hundred more prescription drugs that are not covered by the government formulary.
If you don't see the answer to your question, please contact us.