Drugs and pharmacy benefits

Find information about coverage for prescription drugs and over-the-counter products under the Non-Insured Health Benefits (NIHB) program.

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About drugs and pharmacy benefits

The program covers prescription and over-the-counter medications that are:

Exception drugs are not listed in the drug benefit list but may be approved in special circumstances.

The program provides eligible clients with coverage for benefits not otherwise available under federal, provincial, territorial or private health insurance.

Drug benefit list

The Drug Benefit List is a listing of the drugs provided as a benefit by the Non-Insured Health Benefits (NIHB) Program. The listed drugs are those primarily used in a home or ambulatory setting.

The purpose of the Drug Benefit List is to:

The Drug Benefit List is generally updated on a quarterly basis.

A prescription from a licensed practitioner is required for any listed drug to be processed as a benefit. Practitioners are those people authorized to prescribe drugs within the scope of practice in their province or territory.

The information contained in this electronic version of the Non-Insured Health Benefits Drug Benefit List requires knowledgeable interpretation and is intended primarily for professional health care practitioners, pharmacies, hospitals and organizations associated with the manufacture, distribution and use of pharmaceutical preparations.

To receive a print copy, providers must obtain a fax request form from one of the Non-Insured Health Benefits Toll-Free Inquiry Centres.

How to access drugs and pharmacy benefits

You can access the drugs and pharmacy benefits from a licensed pharmacy.

Providers who are enrolled in the program generally send in claims to bill the program directly. This means you do not have to pay a deductible or co-payment. You will need to show client identification in order for providers to bill the program directly.

Express Scripts Canada administers claims for providers on behalf of the program. This website includes:

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