Prescription Drugs & Vaccinations

Health Benefits

Prescription Drugs and Vaccinations

Your Health Plan will cover your eligible prescription drug costs and vaccinations up to 80% (inlcuding Accutane), up to a maximum of $2,000 per person, per benefit year. The Plan covers most medications legally requiring a prescription, either the generic equivalent or the lowest actual cost.

The AMS Health Plan only covers those medications listed in the National Formulary or in the Special Authorization Formulary (NASA), including most oral contraceptives, insulin and diabetic supplies. Certain brand name drugs are covered only if your doctor indicates on the prescription "no substitution".

Vaccinations, including HPV vaccinations, that require a prescription and that are listed in the NASA Formulary, and non-prescription vaccinations not covered by provincial health care are covered at 80%.

Visit www.myams.org/health for the listing of medications on the NASA Formulary.

Smoking cessation devices are covered at 80%, up to a maximum of $500 per policy year. You need a prescription for smoking cessation devices - you must send in a copy of your prescription in order for Sun Life to process the claim. A detailed pharmacy receipt is also required, clearly indicating the device purchased. Over the counter smoking cessation devices are not covered.

Please note the following medications are not covered whether or not prescribed by a physician: vitamin products, patent medicines, blood and blood plasma, contraceptive devices other than oral contraceptives and IUDs, sexual dysfunction medications, antacids and experimental drugs that have not been approved by Health Canada.

Dispensing Fee
Eligible expenses for the dispensing fee are limited to $5 for each prescription or refill. This means that you will have to pay 100% of that portion of the dispensing fee above $5. If your prescription permits, you are entitled to be dispensed up to a 120-day supply of your medication for a single dispensing fee. Note: not all pharmacists charge the same amount; visit www.myams.org/health for a listing of local pharmacists' dispensing fees.

Payments for any single purchase are limited to quantities that can reasonably be used in a 34-day period, or, in the case of certain maintenance drugs, in a 100-day period as ordered by a doctor. For oral contraceptives, payments for any single purchase are limited to the cost of a supply that can reasonably be used in a 120-day period.

Exception Process
In the event that the drugs covered are not effective in treating the condition, an exception process is in place. Click here to download or print a Drug Exception Form. Contact studentcare.net/works at 1 877 795-4420 or the AMS Front Desk for any additional information concerning prescription drugs.

Health-care networks

Discover the Networks’ Advantages

claims

coverage

download centre

About us