Medication coverage can vary significantly based on your province of residence, insurance provider, and the specific terms of your benefits plan.
Our partner pharmacy will submit claims directly to your insurance or benefits provider; however, please note that pre-adjudication is not available. This means we are unable to confirm your exact coverage amount prior to processing your first fill.
Once your prescription has been processed, any remaining out-of-pocket costs will be charged to your credit. You will also receive an email with a detailed cost breakdown.
📌 If you have private insurance or a provincial health card, please ensure this information is uploaded under the Billing & Shipping tab of your account to facilitate accurate billing.
Here's a breakdown of the different types of coverage.
🏥 Private Insurance
Most workplace/private plans provide coverage (full or partial) for birth control. Upload your card in the Billing and Shipping tab of your account.
Our pharmacy partner will apply any available insurance coverage at the time your prescription is filled
Please note that generic medications are typically more likely to be covered than brand-name alternatives
🍁 Provincial Plans
Ontario Drug Benefit (ODB)
Includes:
OHIP+, ODSP, and Ontario Works
To qualify for OHIP+ coverage:
You must be under 25 years of age
You must not have private insurance coverage
The prescribed birth control medication must be listed on the Ontario Drug Benefit (ODB) formulary
British Columbia – PharmaCare
PharmaCare now covers many common birth control options as of April 2023.
Please upload clear images of both sides of your BC Services Card.
Felix will bill PharmaCare directly for any eligible prescriptions.
More information: Fair PharmaCare
For more details on provincial health plan coverage, see below:
Currently, our partner pharmacies are located in Ontario and British Columbia, so we’re unable to bill other provincial plans directly.
To ensure coverage, we recommend sending your Felix prescription to a local pharmacy. You can do this at checkout by selecting “Pickup at external pharmacy” under your shipping address, then entering your local pharmacy’s name and fax number.
NIHB (First Nations & Inuit)
Most birth control options are covered under NIHB. Learn about NIHB eligibility
Upload your status card or NIHB number in the Billing and Shipping tab.
If you also have private insurance, upload that too — NIHB acts as a secondary plan.
⚠️ Why Was I Charged the Full Amount?
You might see the full charge if:
Special authorization is required
You have requested an early refill
You’ve reached your plan's maximum limit
✅ What To Do:
Review your plan details using the resources linked above to better understand your coverage
Upload your insurance card along with any applicable provincial health ID (e.g., OHIP, BC PHN) to the Billing and Shipping tab of your account
Reach out to our team anytime via chat within your account of at felixforyou.ca/contact