Some Notes on Private Drug Plans

You may have a private drug plan through your employer.

This is currently¬† very much a moving target. Employers are facing dramatically rising costs for providing plans for their employees, rising anywhere from 10 -100% per year, and often calculated annually based on the previous year’s drug costs.

There are 140 000 drug plans in Canada, and 200 different drug formularies, in a market covering $10 billion worth of drugs (in the private sector only).

The bubble will burst soon because the current cost of medication is not sustainable.

Our advice is:

1. Never assume your medication is covered until you have checked. One insurance company will have many plans, with different  drug exceptions and different ceilings

2. Your drug plan may change and alter coverage.

3. Some companies will mandate certain companies and case support workers – the aim is always to save money!

4. If you have a plan that works, take careful advice before changing plan as you will subsequently have a “preexisting condition”

5. If we follow evidence based  practice which reflects Provincial guidelines on drug access this is the best way to protect our patients from future loss of coverage through changes in plan, relocation or retirement.

 

We have many patients who have found themselves with very high bills for medication, owing to their assumptions of coverage which were incorrect. Do not allow this to happen to you!