Catastrophic Drug Funding

PROGRAM DETAILS

Will you be forced to choose between bankrupting your family and declining life-saving treatments?

Did you know...?

  • Only prescription drugs administered inside a hospital are covered by the Canada Health Act

  • Due to our patchwork drug coverage system, provincial healthcare plans are not required to pay for drugs taken outside of a hospital, even when they are medically necessary

  • Oral medications for cancer treatment will cost a Canadian family $6,000 per month, on average

  • Your company's benefits plan does not cover all medications, has limits on treatments, and can be changed or cancelled at any time

The Catastrophic Drug Funding program provides unlimited 100% funding for qualified prescription drug expenses that exceed $4,500 in a year, when your provincial healthcare plan does not cover those costs.

This funding provides the following benefits:

  • Offers relief from the overwhelming out-of-pocket costs of prescription drugs for serious illnesses and chronic health conditions

  • Protects you against the rising costs of medications

  • Closes the gaps in your provincial healthcare plan

  • Extends the limited coverage on your company's employee benefits plan
  • Complements and expands on the benefits of other healthcare funding programs, such as the Cancer and Illness Funding program

  • Ensures you won't be forced to choose between bankrupting your family and declining life-saving treatments

  • Ensures you won't need to ration your medications or try to decide which drugs are more important to your outcome

  • Enables you to free up your income and savings for other expenses

Built-In Additional Benefits

  • Homecare Benefit: If you require homecare services, and your annual expenses exceed $7,500, you will receive up to $25,000 per year of additional funding for homecare and nursing services, prosthetic appliances, and durable medical equipment. The lifetime maximum funding for the Homecare Benefit is $100,000.

  • Hospitalization Benefit: If you are in an accident that results in a hospital stay of at least 24 hours, you will receive funding for unlimited chiropractic and physiotherapy services for 1 year following the accident.

 

LUCY'S STORY

 

Lucy and Nolan worked hard to make things work - juggling careers, active children, aging parents, mortgage and car payments, and student loans.

Then one day, shortly after her 38th birthday, everything changed with Lucy's breast cancer diagnosis.

An oncologist recommended an oral treatment for Lucy’s type of cancer, but the Ontario Health Insurance Plan (OHIP) refused to pay for the pills. Since Lucy’s company didn’t offer health benefits, they turned to Nolan’s company plan, which covered 85% of the drug’s $6,500 monthly costs. However, Nolan’s employer changed their employee benefits provider the next year, and the new plan did not cover those drug expenses.

Even though they both had good careers and a good income, there was no way Lucy and Nolan could afford the cancer treatments, and that didn't even take into account their ongoing mortgage, car, and student loan payments.

Luckily, Lucy planned ahead with a Catastrophic Drug Funding program, which provided funding for her cancer treatments, leaving the family to only pay $4,500 instead of the full $78,000 that year.

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SAMPLE PROGRAM CONTRIBUTION RATES

Program contribution rates can vary and are subject to change. These rates are strictly for illustrative purposes.

 

 

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