Your pay-direct benefits card makes it easy and convenient when filling a prescription. Your drug claim gets processed right at the pharmacist’s counter and instantly you are told the amount paid by your plan and any amount owing. How did the pharmacy determine this amount for your drugs? Why is it important to have limits on pharmacy mark-ups and dispensing fees?
As per your benefits booklet, your prescription drug plan includes mandatory generic substitution and limits on dispensing fees to help manage the costs associated with prescription drugs. If you share in either the cost of your plan or the cost of your prescription, these limits may help you save some money!
Price of your prescription
Although costs vary depending on where you shop, three factors determine the price of prescription drugs:
NOTE: In the province of Quebec, pharmacists are not required to provide a breakdown of the drug cost, mark-up and dispensing fee.
There is no limit to what a pharmacy can charge for a prescription. Pharmacists can charge any mark-up or dispensing fee that is considered standard for their store or company. By integrating limits on drug costs, dispensing fees and mark-ups in your benefits plan, your Employee Life and Health Trust is protecting members from unusually high prices and managing drug costs to ensure your plan remains financially sustainable.
Here are some cost-saving ideas for filling prescriptions:
Learn more about dispensing fees and how to save money on your prescriptions.
Questions about your drug coverage? You can contact OTIP Benefits Services at 1-866-783-6847.
Sources:
Understanding Limits pharmacy mark-ups and dispensing fees, Manulife GC2148E, 07/15