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Extended Drug and Health Benefits

Overview

For people with episodic disabilities, staying healthy for longer periods — and reducing the severity of periods of illness when they do occur — is a key factor in improving their employment opportunities. Stable access to medication is therefore an important consideration.

There are a number of things to know about accessing public extended drug and health benefits:

  • Through social assistance from your province or territory, you’re eligible for drug benefits, too.
  • In some jurisdictions, this coverage is discontinued after a return to work — ask your provincial/territorial income support specialist if your drug benefits continue after a return to work and for what length of time.
  • Some jurisdictions allow continued access to drug benefits if your drug costs aren’t otherwise covered, and reimburse medical expenses beyond a specific amount.

Extended drug and health benefits may also be available through a private insurance plan:

  • Through your employer;
  • Through a spouse/partner; or
  • By purchasing a health benefits plan.

If you have access to extended drug and health benefits through your employer or your spouse/partner, find out what you qualify for and the different plans available. Note that some plans have pre-existing condition clauses that may affect your eligibility.

If you’re buying your own plan or have a plan through an employer, you’ll likely have the option of choosing either a basic plan or an extended one. Most basic plans cover essential health care needs, such as dental and vision care, travel insurance, and accidental death or dismemberment insurance. Extended plans cover needs not insured by either public or private basic plans — registered massage therapy, osteopathy, naturopathy and speech pathology are just some examples.

Some employers offer extended benefits that you pay for yourself, either in part of completely. Ask your employer what different types of plans are available — and keep this in mind when considering a move from one employer to another. You might be eligible for basic private health plans without answering medical questions. Some plans only require health-related information when applying for more extensive health benefits.

FAQs

Q - My employer doesn’t offer drug benefits and my province/territory doesn’t offer medication coverage because I’m employed. Do I have any other options?

A - Many provinces/territories offer drug and health benefits coverage if you are unable to cover the cost of medications and health benefits through private insurance coverage. There may be an application process; each province/territory has its own eligibility requirements. For information on the benefits offered in your province/territory, search the World Wide Web for the name of your province/territory and “extended drug and health benefits.”

Q - If I try to access extended health benefits through my spouse/partner, to whom will I need to disclose my episodic disability?

A - For most insurance plans, you will only need to disclose your episodic disability to the insurer. Insurance programs that are self-financed through an employer are an exception to this rule.


Q - If I have benefits through my employer, do I need to send paperwork with information on my episodic disability through my employer?

A - Many employers will allow you to send your paperwork directly to the insurer. If paperwork is being processed through your employer, you can place all documentation in a sealed envelope.

Resources

Sponsored By:
Mac AIDs Fund Logo
This project is funded in part by the Government of Canada’s Social Development Partnerships Program – Disability component.

Realize (formerly CWGHR) also acknowledges the financial support of the Public Health Agency of Canada.
The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada