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A dispensing fee is a fee charged by your pharmacist to cover the cost of their service.
This fee can range anywhere from $4 to $16 for each prescription you fill and can vary from one pharmacy to another. We encourage all our members to shop around to ensure they’re getting the best service for the lowest fees.
Dispensing fees are regulated differently in the provinces of Quebec and Saskatchewan.
Coverage may vary in both provinces.
Yes, however, there are limits on dispensing fee coverage for certain maintenance medications.
You can find your limits in your benefits booklet in the 'Coverage' section within our Member Services site or Blue Cross Mobile. You can also contact Customer Service.
For many plans, the coverage applies for up to five dispensing fees, per maintenance medication, per 12-month period*. A maintenance medication should be dispensed in a three month dose to ensure you do not surpass your dispensing fee frequency limit.
Maintenance drugs/maintenance medications are prescription drugs that require regular/daily use, commonly used to treat conditions that are considered chronic or long term. A few examples of maintenance drugs that can have a limited dispensing fee include drugs to treat high blood pressure, heart disease, cholesterol, asthma, diabetes, etc.
When will the dispensing fee frequency limit start to apply?
The dispensing fee frequency limit applies after a maintenance drug prescription has been claimed for three months.
If you get a new prescription, you're in what’s known as the 'trial phase'. After three months, you enter the 'maintenance phase', and your dispensing fee frequency limit applies.
How do I find out if one of my prescription drugs has a limited dispensing fee?
Your pharmacist will be able to inform you if any of your prescription drugs qualify to the dispensing fee frequency limit at the time of claim. We have a built-in feature on our system that will send them a message if any future claim in the remainder of the benefit period will not accept the dispensing fee. You can also contact us for clarification on any dispensing fee limits.
Some maintenance drugs can’t be dispensed in a three month supply. Your pharmacist is aware of these exceptions and will know what to do to ensure you don’t have to pay dispensing fees out of pocket once you exceed the maximum allowed by your drug plan.
Additionally, if you or your health care professional (prescribing doctor, pharmacist, nurse) have concerns about getting a three month supply for a prescription drug on the list with Dispensing Fees frequency limits we encourage you to contact us to explore your options.
If your pharmacist refuses to dispense a three month supply for a drug included on our list of eligible maintenance drugs because they have concerns, they can fill a dispensing fee program exception form explaining the medical reasoning behind their decision.
If a participant chooses to fill their prescription more frequently, they will be responsible for paying any additional dispensing fees for the maintenance drug.
Yes. We understand that some maintenance drugs can’t be dispensed in a three month supply due to patient safety, storage guidelines, cost, and monitoring reasons. This includes drugs dispensed in a blister pack (also called bubble pack, multi-dose dispensers, or Dispill®). Pharmacists are aware of these exceptions can help members manage dispensing fees.