Helping you better manage drug claims for children and seniors in Saskatchewan

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We’re making a change to our systems to help better manage drug claim costs for children and seniors in Saskatchewan.

This change only applies to pay-direct drug plans at this time.

The enhancements will help ensure that drug claims are directed to the government drug plans first.

  • The Children’s Drug Plan ensures drug costs for children (age 14 and under) are capped at $15 per prescription, for drugs listed on the Saskatchewan Formulary. All children are automatically registered.

If we receive drug claims that haven’t gone to the provincial children’s program first, a message will be generated telling claimants that the drug is covered by another program.

  • The Seniors' Drug Plan has an income-based eligibility requirement. Seniors must apply to the government program and, if accepted, they only pay up to $15 per prescription for drugs listed on the Saskatchewan Formulary.

To allow us to properly coordinate claims, we ask that seniors let us know if they have applied and are not eligible for the provincial Seniors’ Drug Plan. Please note: Unless we hear otherwise, we will assume that seniors are eligible for the government program.

If we receive a drug claim that hasn't gone to the government plan first, and if our records indicate that the claimant is eligible, a message will be generated telling the pharmacy that the drug is covered by another program.

What you can do

The Saskatchewan government has made seniors aware of the application process. To ensure eligible seniors register, you may want to remind them to apply to the government program and to provide Sun Life with a copy of the reply if they are not eligible. The attached communication for seniors will help explain how members should submit the information to Sun Life.

These changes do not affect our current claims thresholds or processes for Saskatchewan plan members for the Special Support Program.

Questions?

Please contact your Sun Life Financial group representative.