Pay-Direct card / Drug card

A pay-direct card, also known as a drug card, is a plastic or digital card issued by your health insurance provider that allows pharmacies to bill your insurer directly for eligible prescription drugs. Instead of paying the full cost upfront and submitting a claim later, you pay only your portion - such as a deductible or coinsurance - at the point of sale.

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This system simplifies the claims process, reduces out-of-pocket expenses, and provides immediate access to your drug benefits. When the card is presented at a participating pharmacy, the pharmacist inputs your policy details electronically, and the insurer pays its share of the eligible cost directly to the pharmacy. The remaining balance, if any, is paid by you.

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Most health and dental plans in Canada now include pay-direct functionality for prescription drugs, and some also extend it to vision care or paramedical services where electronic claims systems are available.

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Example:

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If your plan covers 80 percent of eligible drug costs and a prescription costs $100, the pharmacy uses your pay-direct card to bill your insurer for $80, and you pay $20 at the counter.

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What to Watch For:

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Ensure the pharmacy is part of your insurer’s electronic claims network. Keep your card current, as coverage details or policy numbers may change after renewal. Always verify that the prescribed medication is eligible under your plan’s drug formulary before purchasing.