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Smoking-Cessation Drugs

Smoking-cessation drugs are prescription medications designed to help individuals quit smoking by reducing nicotine cravings and withdrawal symptoms. Examples include bupropion and varenicline. These medications are considered lifestyle-related but medically supported treatments.

Not all health plans cover smoking-cessation drugs, and those that do often impose small annual or lifetime maximums. The coverage may also include nicotine replacement therapy if prescribed by a doctor.

Example:

If your plan covers smoking-cessation drugs up to $500 per lifetime and your prescription costs $275, you can claim $225 more in the future.

What to Watch For:

Check for lifetime limits and whether the medication must be prescribed by a physician to qualify. Over-the-counter nicotine patches are usually excluded unless stated otherwise.

Related Terms

Shared Dispensing Fee / Fee Limit

The shared dispensing fee, or fee limit, refers to the portion of a pharmacy’s dispensing charge that your insurance plan will cover. Pharmacies add this professional fee each time a prescription is filled to cover handling, verification, and counselling.

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.

Prescription Drugs

Prescription drugs are medications that can only be dispensed by a licensed pharmacist with a valid prescription from a qualified healthcare professional, such as a physician or nurse practitioner. These drugs are used to treat, manage, or prevent medical conditions and form one of the core components of most extended health care insurance plans. Prescription drug coverage helps offset the cost of medications that are not funded by provincial or territorial health programs.

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.

Health Insurance

Health insurance is a type of coverage that helps pay for medical and healthcare expenses not fully covered by Canada’s public health system. It protects individuals and families from the high cost of prescription drugs, medical services, and treatments that fall outside provincial or territorial government health plans. Health insurance can be obtained through an employer’s group benefits plan or purchased individually from a private insurer.

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