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Drugs

Review your prescription drug coverage eligibility, reimbursement rates, and yearly maximums — which vary based on your age, plan type, and whether you're over 65 with Alberta Seniors Benefit as first payor.
Review your prescription drug coverage options with ASEBP MyRetiree Plan's generic alternative pricing for retired educators
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Drugs

ASEBP offers comprehensive drug coverage for the MyRetiree Plan. Here are the basic eligibility criteria for prescription drugs:

  • Prescribed by a doctor or other licensed health care provider in Canada
  • Dispensed by a licensed Canadian pharmacy
  • Purchased in Canada, and while you or your dependants are covered under the plan
  • Being used for their intended purpose as defined by Health Canada 

You can find your plan details on My ASEBP or under My Benefits on the My ASEBP Mobile App.

Note: over-the-counter drugs, even if prescribed, are not eligible for coverage.

The amount of coverage applies to the following, depending on:

Maximums and percentages reimbursed are noted where applicable.

Enhanced

50-64 Years

  • No yearly maximum
  • Per person per calendar year (January-December)
  • 100% reimbursed for eligible drug claims

Over 65 (Alberta Seniors Benefit plan is first payor)

  • *Yearly max $5,000 (applies to dependants regardless of age)
  • Per person per calendar year (unless otherwise noted)
  • 100% for eligible drug claims

Core

50-64 Years

  • No yearly maximum 
  • Per person per calendar year (January-December)
  • 70% reimbursement for eligible claims up to $20,000 
  • 100% reimbursement for eligible claims beyond $20,000

Over 65 (Alberta Seniors Benefit plan is first payor)

  • *Yearly max $3,500 (applies to dependants regardless of age)
  • Per person per calendar year (unless otherwise noted) 
  • 70% reimbursed for eligible drug claims 
*If you join the plan after age 65: drug maximums are effective upon enrolment. If you’re already enrolled in the MyRetiree Plan when you turn 65, drug maximums become effective on January 1 following your 65th birthday.

What's Covered

Note that the following is a comprehensive summary of the official, legally binding ASEBP insurance policies and plan documents available through your employer or by contacting us.
01

Advisories

Stay informed about drug recalls, safety warnings, and Health Canada advisories that may affect your prescriptions and coverage.
More Details
02

Biosimilar Drugs

Understand what biosimilar drugs are, how Alberta's Biosimilars Initiative may affect you, and what it means for your ASEBP coverage.
More Details
03

Brand and Generic Drugs

Learn the difference between brand-name and generic drugs, and how generic medications offer the same dosage, strength, and quality after the original patent expires.
More Details
04

Dispensing Fees and Compounding Drugs

Review the maximum dispensing fees covered — $9 for standard prescriptions and prepackaged compounds, $13.50 for pharmacy-prepared compounds — and eligibility requirements for compound medications.
More Details
05

Dispensing for Maintenance Medications

Learn how the five-refill-per-year limit on maintenance medications works, and how exceeding it may result in out-of-pocket dispensing fees.
More Details
06

Early Refills

Find out when you're eligible to refill a prescription (70% of your supply must be used), plus how to request extra medication before traveling.
More Details
07

Enhanced Special Authorization

Learn why the Enhanced Special Authorization process was retired in 2023 and how all specialty drug requests are now handled through the standard special authorization process.
More Details
08

Sexual Dysfunction Medications

Review your $800 per person annual maximum for eligible sexual dysfunction medications, covered at 100% (Enhanced) or 70% (Core).
More Details
09
Basic Detailed

Joint Injectable Materials

See your $1,000 per person annual maximum for eligible joint injectable drugs and materials, covered at 100% (Enhanced) or 70% (Core).
100%
Enhanced
70%
Core
More Details
10
Basic Detailed

Generic Alternative Pricing

Understand how your drug coverage is based on the lowest-cost generic alternative, and when choosing a brand-name drug may result in out-of-pocket costs.
100%
Enhanced
70%
Core
More Details
11

Life Sustaining Over-the-Counter Exception List

See which life-sustaining OTC medications — including injectable epinephrine, insulin, glucagon kits, nitroglycerin, and potassium supplements — are covered as exceptions under your plan.
More Details
12
Basic Detailed

Maintenance Medication Program

Learn which nine drug classes qualify as maintenance medications, how the five-dispensing-fee limit works, and why filling a three-month supply can save you money.
100%
Enhanced
100%
Core
Reimbursement for eligible claims beyond $20,000
70%
Core
Reimbursement for eligible claims up to $20,000
More Details
13

Migraine Medications

Find out how migraine medications like Emgality and Aimovig require Alberta Blue Cross Special Authorization, and what your specialist needs to submit for approval.
More Details
14

Sclerotherapy

Review coverage for drugs used in varicose and spider vein treatment procedures, and note that ultrasound-guided sclerotherapy is not covered.
More Details
15
Basic Detailed

Smoking Cessation

Check your $1,500 lifetime maximum for eligible smoking cessation prescription drugs, covered at 100% (Enhanced) or 70% (Core).
100%
Enhanced
70%
Core
More Details
16

Special Authorization

Understand which drugs require special authorization, how your doctor submits the request form, and where to find your approval decision in My ASEBP.
More Details
17

Step Therapy Program

Learn how the Step Therapy Program requires trying a first-line drug before second-line options are covered for overactive bladder, asthma, and diabetes medications — and when special authorization may apply.
More Details
18

Vaccines

Check your coverage for preventative and travel vaccines, and remember to access provincial programs for free or subsidized vaccines before submitting a claim.
More Details
19

Therapeutic Alternative Reference Pricing

Learn how the TARP program works for four common conditions — stomach hyperacidity, high blood pressure, pain/inflammation, and migraines — and your options if your prescribed drug has a lower-cost preferred alternative.
More Details

What's Not Covered

There are a number of products and services not covered under the plan.  
View What's Not Covered

Ready to secure your retirement benefits?

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Suite 301, 6104-104 Street NW
Edmonton, AB T6H 2K7

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Retirement on your mind?

Join ASEBP and guest presenters from Local Authorities Pension Plan (LAPP), Alberta Blue Cross, Greenshield, and Alberta Teachers’ Retirement Fund (ATRF) on Thursday, April 9 from 3:30 - 6:30 p.m. and/or Saturday, April 18 from 9 a.m. to noon to learn more about retirement finances, pension options, and the journey into retirement lifestyle.

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  • Ready to Retire?
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    ASEBP wants to hear from you!

    ASEBP hosting a one-hour virtual focus group to gain insight into your experiences with MyRetiree Plan benefits and how ASEBP can better serve you.  

    Your feedback will help ASEBP better serve you, a valued covered member! 

    Format: Online 
    Date: Tuesday, September 2 
    Time: 2:00 to 2:50 p.m. 

    RSVP by August 29
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    Notice

    Canada Post may decide to strike as early as May 23. Find out how this will affect your benefits claims and/or claim reimbursements.

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