Prescription Benefit Plan

Prescription drug benefits, up to the amount shown in the Schedule of Benefits, that:

a) are prescribed by a legally qualified medical practitioner or dental practitioner as permitted by law;
and
b) legally requires a prescription and has a Drug Identification Number (DIN);
or
c) are paid on a Pay Direct basis.

If approved by Green Shield, this plan includes drugs with a Drug Identification Number (DIN) that do not legally require a prescription, including insulin and all other approved injectables, as well as related supplies such as diabetic syringes, needles and testing agents.

Certain drugs may require prior approval. Your Pharmacist is aware of the drugs that fall into this category.

In no event will the amount dispensed exceed a three-month supply (six months if a vacation supply is required) of a prescription at any one time and not more than a 13-month supply in any 12 consecutive months.
Sherwin-Williams Drug program is based on a Tiered Formulary. See page 10 of the GSC booklet for details.

NOTE:

Drug Benefit over age 65: The Drug Benefit co-pay and the deductible (where applicable) in your province of residence is an eligible benefit.

Quebec residents only: Legislation requires Green Shield to follow the RAMQ (The Regie de l’assurance maladie du Quebec) reimbursement guidelines for all residents of Quebec. If you are younger than age 65, you must enroll for the Green Shield Prescription Drugs benefit plan and Green Shield will be the only payer. If you are age 65 or older, enrollment in RAMQ is automatic, enrollment in the Green Shield Prescription Drugs benefit plan is optional, and RAMQ would be first payer.

If any provisions of this plan do not meet the minimum requirements of the RAMQ plan, adjustments are automatically made to meet RAMQ requirements.

Eligible benefits do not include and no amount will be paid for:

a) Smoking cessation products and drugs for the treatment of erectile dysfunction;
b) Products which may lawfully be sold or offered for sale other than through retail pharmacies, and which are not normally considered by practitioners as medicines for which a prescription is necessary or required,
c) Ingredients or products which have not been approved by Health Canada for the treatment of a medical condition or disease and are deemed to be experimental in nature and/or may be in the testing stage;
d) Mixtures, compounded by a pharmacist, that do not conform to Green Shield’s current Compound Policy.

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Need assistance? Contact one of our Benefits Centre Administrators to assist you with your needs

Sherwin-Williams Canada Benefit Service Center
30 Kelfield Street
Toronto, ON M9W 5A2
Phone: 1-844-994-9989
Email: sherwin@benefitscentre.ca