Prescription medications are commonly listed among the benefits included with Visitors to Canada insurance.
The same principle applies to policies suitable for Super Visa applicants, International Experience Canada (IEC) participants, new immigrants, foreign workers, and returning Canadians. However, this doesn’t necessarily mean that every prescription you need while in Canada will be covered.
Visitors to Canada insurance is primarily designed to cover unexpected medical emergencies. As a result, prescription drug coverage is generally connected to the sickness or injury being treated rather than functioning like a regular prescription drug plan.
So, when can your medication be covered and when might you have to pay for it yourself?
Prescription Drugs Following a Medical Emergency
In general, prescription medication may be eligible for coverage when it is medically necessary as part of the treatment for a covered emergency.
For example, imagine that you develop a urinary tract infection while visiting Canada. You visit a doctor, who diagnoses the infection and prescribes a course of antibiotics. If the illness itself qualifies for coverage under your policy, the prescribed medication may also be considered an eligible expense.
The same principle can apply to medication prescribed following an unexpected injury or another covered illness.
This distinction is important: the prescription benefit is generally tied to the covered medical event that resulted in the medication being prescribed.
What About Your Regular Medications?
This is where an important distinction needs to be made.
Visitors to Canada insurance isn’t intended to pay for medications you were already taking before your trip.
If you regularly take medication for blood pressure, cholesterol, diabetes, or another ongoing condition, purchasing Visitors to Canada insurance doesn’t normally turn those prescriptions into covered expenses.
For this reason, travellers who take regular medication should plan ahead and make sure they have an adequate supply for their trip whenever possible.
If your existing medication changes or you require treatment related to a pre-existing medical condition while travelling, the situation becomes more complicated. Coverage may depend on your policy’s provisions regarding pre-existing conditions and whether the condition met the required stability period before coverage began.
Prescription Coverage May Have Its Own Limits
Another detail that can easily be overlooked is that prescription medication benefits may have limits separate from your overall emergency medical coverage.
A policy with $100,000 or $150,000 in emergency medical coverage does not necessarily provide the same amount for prescription drugs.
Depending on the insurer and plan, prescription coverage may be restricted by a maximum dollar amount, the number of days of medication supplied, or other policy conditions. Some plans, for example, limit eligible outpatient prescriptions to a 30-day supply.
This is one of the reasons it’s important to look beyond the overall coverage amount when comparing Visitors to Canada insurance policies.
Two plans with the same emergency medical limit may provide different benefits for individual expenses such as prescription medications, follow-up care, or other services.
What If You’re Prescribed Medication in the Hospital?
Medication administered while you’re hospitalized may be treated differently from a prescription you fill at a pharmacy after leaving the hospital.
Hospital treatment usually includes medically necessary drugs administered as part of your emergency care, subject to the terms of your policy. If your doctor then prescribes medication for you to continue taking after discharge, separate limits or conditions may apply to that prescription.
Again, the exact rules depend on the policy you purchased.
Keep Your Receipts and Prescription Information
If you need to purchase medication following a covered medical emergency, keep the documentation associated with it.
This would include your pharmacy receipt, prescription, medical records, and any other documents provided during treatment. Your insurer may require this information when reviewing your claim.
It’s also a good idea to contact your insurer’s emergency assistance centre when seeking treatment. They can explain the claims process and advise you about any documentation or authorization that may be required under your policy.
Don’t Assume Every Prescription Is Covered
Seeing “prescription drugs” in a policy’s list of benefits can make the coverage appear straightforward, but the circumstances surrounding the prescription matter.
A medication prescribed to treat a new and unexpected medical emergency is quite different from a routine refill of medication you’ve been taking for years. Benefit limits, pre-existing condition provisions, and other policy terms can also affect whether an expense is eligible.
We highly recommend that you review the prescription medications benefit included with your policy before traveling, especially if you take regular medication or have an existing medical condition.
Need Help Understanding Your Coverage?
The rules surrounding prescription drug coverage can vary between plans and may not always be immediately clear from a policy’s list of benefits.
At Arbetov Insurance, we’re happy to help you compare Visitors to Canada insurance plans, understand their benefits and limitations, and find coverage that suits your individual needs. If you’re unsure how a particular benefit works, contact our team and we’ll help you better understand your options before you travel.
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