Changes to coverage limits effective January 1, 2021
Friday, Jan 1, 2021There are a number of enhancements and changes to your Retiree Benefits Plan effective January 1, 2021.
We’re pleased to advise that coverages for the following benefits have been enhanced:
- vision care coverage has been increased to $250 every two calendar years for adult members,
- new coverage for eye exams to a maximum of $75 every two calendar years for all members,
- the annual per person per paramedical maximum for all categories is now consistent at $500 per calendar year, which will make it easier for you to track your coverage levels and reimbursements, and
- new coverage for the shingles vaccine for all members.
Note that coverage for oral sleep apnea devices has been removed to align with industry standards.
Changes to drug dispensing fee coverage
New dispensing fee limits are being introduced for a defined set of drugs used to manage chronic conditions (called the Maintenance Drugs list).
Dispensing fees for drugs included on a Maintenance Drugs list will be limited to five per calendar year, although there are some situations in which 13 dispensing fees are covered, allowing for services such as monthly blister packaging, if required. All other oral medications (tablets and capsules) used to treat chronic conditions will be limited to 13 dispensing fees per calendar year.
Medications you use for an acute or a non-chronic condition (drugs you don’t take regularly) or non-oral medications (liquids, inhalers, compounds, injectables) will not be subject to this new limit.
If you are impacted by these new limits, you were notified by mail. We encourage you to discuss this change with your pharmacist to ensure the smoothest possible transition on January 1, 2021.