Lifestyle Drugs
Lifestyle drugs are prescription medications used to improve quality of life rather than to treat or manage life-threatening or medically necessary conditions. These drugs address personal or lifestyle-related concerns, such as sexual performance, hair growth, weight management, or cosmetic enhancement.
How It Works
Most health and drug insurance plans in Canada exclude lifestyle drugs from coverage because they are not considered medically essential. In general, a prescription must be written by a physician, dentist, or psychiatrist, be medically necessary, and carry a Drug Identification Number (DIN) to qualify for drug coverage, yet lifestyle drugs such as smoking cessation aids, fertility, weight loss, and contraceptive drugs are commonly left out of Canadian formularies even when they meet those requirements. Whether an employer covers a lifestyle drug largely depends on its connection to improving employee health, and coverage rates vary widely by condition: a Hewitt Associates survey found 68% of organizations covered smoking cessation drugs, 52% covered infertility drugs, 33% covered obesity drugs, 26% covered erectile dysfunction medication, and only 5% paid for male pattern baldness remedies. Employers may also control these costs through higher employee co-insurance in a two-tier formulary, caps on coverage, or by routing the drugs through a health spending account or flexible benefit option that requires employee contributions.
Example:
Suppose a Canadian on a personal health and dental plan is prescribed a medication for hair loss. Because hair loss is treated as a lifestyle concern rather than a medically necessary condition, the insurer will likely reimburse nothing unless the plan specifically includes a lifestyle drug benefit. The patient should check the plan's drug formulary or exclusion list first, and if the medication has both medical and lifestyle uses, ask their doctor to document the medical necessity to support a claim.
What to Watch For:
Some comprehensive plans may still provide partial coverage for a lifestyle drug if it is prescribed for a legitimate medical condition and approved by the insurer, so having a valid prescription does not by itself guarantee reimbursement. A few personal plans carve out a separate, lower lifestyle-drug benefit within the overall prescription drug maximum, such as Manulife CoverMe's Guaranteed Issue Enhanced plan, which provides a distinct lifestyle drugs sub-limit included in the plan maximum. It is also worth noting that in private drug plans the weight-management category is classified as a lifestyle benefit that plan sponsors must opt into, and TELUS Health reported it grew 104.0% in eligible amounts in 2024 and another 61.0% in 2025.
