Am I Covered?
Medication coverage varies greatly between different plans, provinces and has specific criteria that determine eligibility.
We will take care of direct billing with your insurance/benefits provider, but unfortunately, it is not possible to pre-adjudicate in order to determine your precise coverage before your first fill is processed. We recommend that you reach out to your insurance provider ahead of time to confirm your specific coverage information to get a better idea of how much of your medication costs you will be responsible for.
In some cases, especially for weight loss medications, insurance providers require special authorization forms to be filled out. More info on that can be found here.
Once your first fill has been processed through your insurance, the remaining cost that you've been charged will be updated within your account and you will receive an email confirmation of this breakdown as well.
For private insurance, we recommend that you reach out to your insurance provider and to check your plan manual ahead of time to confirm your specific coverage information to get a better idea of how much of your medication costs you will be responsible for.
For more details on provincial health plan coverage see below:
My Fill was Charged the Full Amount
If you have your insurance uploaded and notice that your fill has been charged the full amount, we highly recommend contacting your insurance provider to clarify your coverage as they should be able to provide further details. Some common reasons as to why a fill may not have been covered:
Special authorization is required (especially for Weight Loss and Metabolic Health)
The refill is too early to be billed through insurance
Plan maximum has been reached
Please note that if you are prescribed a compounded medication, this does not have a DIN and is not eligible to be direct billed to insurance. However, your shipment will include a receipt with all the details needed to submit a claim to your provider.