Overview
For people living with episodic disabilities, staying healthy for longer periods, and reducing the severity of illness when it occurs, are key factors in improving employment opportunities. Stable access to medication plays an important part in making this possible and is therefore an important consideration in the decisions you make.
There are things to know about accessing public, extended drug and health benefits:
- Through social assistance from your province or territory, you’re eligible for drug benefits, too.
- In some jurisdictions, this coverage is discontinued after a return to work — ask your provincial/territorial income support specialist if your drug benefits continue after a return to work and for what length of time.
- Some jurisdictions allow continued access to drug benefits if your drug costs are not otherwise covered and reimburse medical expenses beyond a specific amount.
Extended drug and health benefits may also be available through a private insurance plan:
- Through your employer
- Through a spouse/partner or your parents if you’re a youth, or
- By purchasing a health benefits plan.
If you have access to extended drug and health benefits through your employer or your spouse/partner, find out what you qualify for and the different plans available. Note that some plans have pre-existing condition clauses that may affect your eligibility.
If you’re buying your own plan or have a plan through an employer, you’ll likely have the option of choosing either a basic plan or an extended one. Most basic plans cover essential health care needs, such as dental and vision care, travel insurance, and accidental death or dismemberment insurance. Extended plans cover needs not insured by either public or private basic plans — mental health counselling, registered massage therapy, osteopathy, naturopathy and speech pathology are just some examples.
Some employers offer extended benefits that you pay for yourself, either in part or completely. Ask your employer what different types of plans are available — and keep this in mind when considering a move from one employer to another. You might be eligible for basic private health plans without answering medical questions. Some plans only require health-related information when applying for more extensive health benefits.
FAQs
If I have benefits through my employer, do I need to send paperwork with information on my episodic disability through my employer?
A – Many employers will allow you to send your paperwork directly to the insurer. If paperwork is being processed through your employer, you can place all documentation in a sealed envelope.
If I try to access extended health benefits through my spouse/partner or parents, to whom will I need to disclose my episodic disability?
A – For most insurance plans, you will only need to disclose your episodic disability to the insurer. Insurance programs that are self-financed through an employer are an exception to this rule.
My employer doesn’t offer drug benefits and my province/territory doesn’t offer medication coverage because I’m employed. Do I have any other options?
A – Many provinces/territories offer drug and health benefits coverage if you are unable to cover the cost of medications and health benefits through private insurance coverage. There may be an application process; each province/territory has its own eligibility requirements. For information on the benefits offered in your province/territory, search the web using: (the name of your province/territory), extended drug and health benefits”
The federal government website provides a useful guide to reimbursement for prescription medications in Canada. Select your province/territory for an overview of the provincial/ territorial drug benefit programs and federal programs available.
Resources
- Provincial and Territorial Public Drug Benefit Programs; Government of Canada (needs file upload)
- Insurance and Diabetes, Your Rights – Canadian Diabetes Association
- Disability Insurance for People with MS – Muscular Sclerosis Society of Canada
- Human Rights Issues in Insurance – Ontario Human Rights Commission