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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.

Most health and drug insurance plans in Canada exclude lifestyle drugs from coverage because they are not considered medically essential. Common examples include medications for erectile dysfunction, hair loss prevention, smoking cessation, or weight loss that are taken for non-medical reasons. However, some comprehensive plans may provide partial coverage if the medication is prescribed for a legitimate medical condition and approved by the insurer.

Lifestyle drug exclusions help insurers manage costs while focusing reimbursement on essential therapies like chronic disease management, preventive care, and acute medical treatments.

Example:

If your physician prescribes a medication for hair loss and the drug costs $100 per month, your insurer will likely not reimburse any portion unless the plan specifically includes lifestyle drug coverage.

What to Watch For:

Always check your plan’s drug formulary or list of exclusions before filling a prescription. Even if a lifestyle drug requires a valid prescription, that does not guarantee coverage. If your medication has both medical and lifestyle uses, ask your doctor to provide supporting documentation to clarify the medical necessity.

Related Terms

Prior Authorization

Prior authorization is the process through which an insurer reviews and approves certain medical treatments, procedures, or prescription drugs before they are performed or dispensed. It ensures that the recommended care is medically necessary, appropriate, and covered under the policy before expenses are incurred. Prior authorization helps manage costs and ensures the use of safe, evidence-based treatments that align with clinical guidelines.

Coverage / Benefit

Coverage, sometimes referred to as a benefit, is the range of health or dental services, supplies, or treatments that your insurance plan agrees to pay for under its terms and conditions. Each benefit represents a category of care, such as prescription drugs, dental services, vision care, or paramedical treatments.

Benefit

A benefit is the specific financial protection or coverage provided under an insurance policy. In health and dental insurance, a benefit refers to the payment or reimbursement made by the insurer for eligible medical, dental, or wellness expenses. Each benefit category - such as prescription drugs, dental services, vision care, or physiotherapy - outlines what is covered, how much the insurer will pay, and any applicable limits or conditions.

Treatment

Treatment refers to any medical, dental, or therapeutic care provided by a licensed healthcare professional to diagnose, manage, or improve a health condition, injury, or disease. In the context of insurance, treatment includes all services, procedures, medications, and interventions that are deemed medically necessary to restore or maintain health. It can range from routine doctor visits and prescription drug use to surgery, rehabilitation, and specialized therapies.

Extended Health Care Insurance

Extended health care insurance (EHC) is supplemental coverage that helps pay for medical expenses not covered by your provincial or territorial health plan. It protects you from out-of-pocket costs associated with services such as prescription drugs, vision care, medical equipment, hospital upgrades, emergency travel medical care, and paramedical services like physiotherapy or chiropractic treatments.

Relevant Plans

Plans that relate to Lifestyle Drugs

Alberta Blue Cross - Blue Assured - Basic

Alberta Blue Cross - Blue Assured - Basic

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced

Alberta Blue Cross - Blue Assured - Enhanced

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced+

Alberta Blue Cross - Blue Assured - Enhanced+

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Premium

Alberta Blue Cross - Blue Assured - Premium

Can apply at anytime, at any age.

Have questions about your insurance coverage?

Our licensed advisors can help you understand your options and find the right plan for your needs.