Prescription Drug Expenses.
5.1. Eligible prescription drug expenses chosen module:
a) Prescription drugs and other products provided for under the List of Medications covered by the Basic Prescription Drug Insurance Plan (RGAM);
b) Therapeutic drugs that are not covered under the List of Medications covered by the RGAM, and which can only be obtained by medical prescription from a physician or a dental surgeon and dispensed by a pharmacist or a physician where there is no pharmacist, or prescribed and dispensed by a nurse authorized to do so in remote areas;
c) Drugs available by prescription, for which the therapeutic indication is directly linked to the treatment of the following pathological conditions: - cardiac disorders - pulmonary disorders - diabetes - arthritis - Xxxxxxxxx’x disease - epilepsy - cystic fibrosis - glaucoma If the condition is considered and identified as a serious illness by medical opinion, some non-prescription drugs obtained by prescription may be reimbursed under certain conditions;
d) preventive vaccines, i.e. the cost of the substance, administered by a physician or a nurse, the purpose of which is to prevent or treat an illness.
Prescription Drug Expenses. The following expenses are reimbursed at 75% of the first $600 of eligible expenses, 90% of the next $500, and 100% of any excess, per certificate, per calendar year. The maximum annual contribution is $200 per certificate. The Insurer will reimburse pharmaceutical services and prescription drugs that are covered under the RAMQ's Public Prescription Drug Insurance Plan, as established under the Act respecting prescription drug insurance (CQLR, c. A-29.01). Nonetheless, these services and prescription drugs are not covered in the case of a participant age 65 or over and the latter’s dependents or in the case of a dependent age 65 or over, unless the participant has chosen to insure the prescription drugs under this coverage. Subject to the exclusions below, the Insurer reimburses expenses incurred for prescription drugs other than those mentioned in the previous paragraph and included in the list of prescription drugs of the Association québécoise des pharmaciens propriétaires (AQPP), which are sold by a licensed pharmacist or physician and can only be obtained on prescription by a physician or dentist; as well as prescription drugs specifically used to treat one of the following conditions: • Cardiac disorders • Pulmonary disorders • Diabetes • Arthritis • Xxxxxxxxx’x disease • Epilepsy • Cystic fibrosis • Glaucoma Eligible expenses for a prescribed drug for which there is at least one generic equivalent are limited to the cost of the least expensive generic equivalent. However, if the healthcare professional who prescribed the drug has indicated “No substitution” on the prescription, the amount payable will be based on the cost of the prescribed eligible drug.
Prescription Drug Expenses. Reasonable and customary charges for medically necessary drugs and medicines which are dispensed by a licensed pharmacist or physician and are prescribed by a physician for the treatment of an illness or injury. Note: Smoking cessation aids which require a physician's prescription are limited to a lifetime maximum of a, months supply. Charges for fertility treatment is limited to a lifetime maximum of cycles. If a brand name drug is purchased only the cost of the generic substitute will be reimbursed, unless the Doctor writes on the prescription "no substitution". This benefit is subject to the restrictions outlined in the Master Policy.
Prescription Drug Expenses
