Covered pharmacy services
Several services provided by pharmacists are covered by prescription drug insurance. You can receive these services whether you are insured under the Public Prescription Drug Insurance Plan or a private plan. You will still have to pay for certain covered services when you go to a pharmacy.
Prescription drug insurance covers several pharmacy services. Still, you will have to pay a fee for certain covered services. Your insurer may request a contribution (deductible and co-insurance) for these services, as is the case with covered prescription drugs. To find out more, refer to the page Amount to pay for prescription drugs.
Before obtaining a pharmacy service, inquire about the fees for which you may be billed and the costs for which you may be reimbursed by your insurer. You will then be able to make an enlightened decision.
The pharmacy services covered are set out in the Regulation respecting the basic prescription drug insurance plan. They include tasks performed by pharmacists since 2015. To find out more, refer to the page Nouvelles activités des pharmaciens (French only) on the website of the Ordre des pharmaciens du Québec.
Covered service without cost
- Prescribing laboratory analyses to monitor a drug therapy
Examples of covered services with cost
In addition to dispensing your prescription drugs, your pharmacist offers other services for which you may be billed. Here are some examples:
- Administering a drug for teaching purposes
- Adjusting the dose of a drug prescribed to you to ensure your safety
- Adjusting the dose of a drug to attain a therapeutic target determined by a physician (e.g. diabetes, high blood pressure, migraine)
- Prescribing a drug for which no diagnosis is required
- Prescribing a medication to treat certain minor conditions where the diagnosis and treatment are known
- Extending a physician’s prescription
- Prescribing a test at a pharmacy to measure the International Normalized Ratio (INR) as part of anticoagulant therapy follow-up
- Replacing a drug that is out of stock
A pharmacist assesses your condition before prescribing a prescription drug. You may pay a fee for the assessment even if the pharmacist decides that he/she cannot prescribe the drug. You will then be directed to a physician.
Conditions for access to covered services
You have to present your valid Health Insurance Card to receive covered services. Otherwise, you will have to pay the total cost of the services rendered and then apply for a reimbursement. If you are a recipient of last-resort financial assistance, you must also present your valid claim slip (carnet de réclamation).
All covered pharmacy services are free of charge if you are entitled to free services under the Public Prescription Drug Insurance Plan. To find out more, refer to the page Rates in effect.
You have to present your Health Insurance Card to the pharmacist to receive covered services. Inquire with your insurer to find out the reimbursement procedure.
Certain pharmacy services are not covered, and you will have to pay for them. Here are some examples:
- Placing drugs in a pill organizer at your request, if not medically justified
- Sample taking by a nurse at a pharmacy (e.g. blood test)
- Vaccination (if the vaccine is provided by a public health branch, only the service may be billed, not the product)