Prescription Program

The prescription coverage offered is administered by Sun Life.

After you satisfy the annual deductible, the plan covers most prescriptions at 80%.

The prescription must be written by a physician or dentist and be dispensed by a licensed pharmacist or physician legally authorized to dispense medications. If you purchase a brand name drug when a generic substitute is available, the plan will reimburse only the covered cost of the generic drug. When there is more than one drug that is suitable to treat your condition, our plan allows for reimbursement based on the lowest priced drug. Should you decide to purchase a higher priced drug, you must pay the difference between the ingredient cost for the drug purchased and the ingredient cost for the lowest priced drug. If the doctor provides written direction that the drug is not to be substituted, the full cost of the prescribed product will be covered (provided it is a covered expense under the Plan).

Smoking cessation aids that require a physician's prescription are covered, subject to a lifetime maximum benefit of $500 per individual.

  • Fertility drugs, laboratory tests, X-rays and related ultrasound
  • General supplies
  • Fees for the services of physicians, nurses, technicians, anesthetists, and administrative staff
  • No benefit will be payable for any single purchase of drugs that would not reasonably be used within 90 days from the date of purchase.