Medication coverage can vary significantly depending on your insurance plan, and whether the medication is prescribed for diabetes management or weight loss. Some plans may also have specific eligibility criteria that affect coverage.
Our pharmacy partner will handle direct billing with your insurance or benefits provider. However, please note that pre-adjudication is not available, which means we cannot confirm your exact coverage amount until your first fill has been processed.
Once your prescription has been submitted and processed, any remaining out-of-pocket costs will be charged to your credit card. You’ll receive an email with a detailed breakdown of the charges as well as a prescription receipt with your medication.
Here's a breakdown of the different types of coverage.
🏥 Private Insurance
Some insurance plans may provide coverage for medications such as:
Ozempic
Wegovy
Saxenda
Mounjaro
To confirm whether your plan covers a specific medication, please contact your insurance provider with the drug name and Drug Identification Number (DIN). If you're unsure of the DIN, our Patient Support team can provide it—just reach out via the chat in your account or visit felixforyou.ca/contact.
📌 Be sure to upload your insurance card under the Billing & Shipping tab in your account. Any eligible coverage will be applied automatically by the pharmacy at the time of fulfillment.
🍁 Provincial Plans
Ontario Drug Benefit (ODB)
Covers:
Ozempic only for type 2 diabetes with a Limited Use (LU) code
Does not cover:
Ozempic (for weight loss)
Wegovy
Saxenda
Mounjaro
British Columbia – PharmaCare
Only covers Ozempic for diabetes with Special Authority
Does not cover:
Ozempic (for weight loss)
Saxenda
Wegovy
Mounjaro
🛑 Mounjaro is not currently covered by any provincial drug plan in Canada.
NIHB (First Nations & Inuit)
NIHB does not cover:
Ozempic for weight loss
Saxenda
Wegovy
Mounjaro
Ozempic is only covered if prescribed for type 2 diabetes (in combination with metformin).
⚠️ Why Was I Charged the Full Amount?
Even with insurance uploaded, you may be charged the full amount if:
Special authorization is required (common for weight loss medications)
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