I am in Ontario and I am a federal employee. I have contacted Sunlife and this is what I got from them:
Thank you for contacting Sun Life Financial. I welcome this opportunity to assist you.
The Customer Care Centre is currently experiencing higher than anticipated email and secured message volumes, resulting in longer than normal response times. We sincerely apologize for this inconvenience. Under the Public Service Health Care Plan (PSHCP), prescription drugs are eligible, provided they meet plan requirements.
To be eligible, the expenses must be:
• The reasonable and customary charges,
• Prescribed by a physician, dentist, or other qualified health professional if the applicable provincial/territorial legislation permits them to prescribe the drugs, and
• Dispensed by a pharmacist or physician. Drugs must legally require a prescription and be identified in the Monographs section of the current Compendium of Pharmaceuticals and Specialties as a narcotic, controlled drug, or requiring a prescription, unless they are otherwise specifically listed as eligible expenses in the plan.
The Cetrotide 0.25MG Injection (DIN 02247766), Crinone 8% Vag Gel (DIN 02241013), Gonal-F 5.5MCG Injection (DIN 02248154), Gonal-F 300U/0.5ML Pen (DIN 02270404), Gonal-F 450U/0.75ML Pen (DIN 02270390), Gonal-F 900U/1.5 ML Pen (DIN 02270382), Luveris 75 Units Vial (DIN 02269066) and Serophene 50MG Tablet (DIN 00893722) are all eligible and will be reimbursed at 80 percent of the reasonable and customary charge, provided your coverage is in force at the time the expenses are incurred.
This drug can be claimed up to a 100 days’ supply, per claim. If a generic equivalent is available, consideration will be based on the cost of the generic rather than the cost of the brand name. Your pharmacist will be able to tell you if a generic is available. Please note that should your Doctor feel that the generic version of this drug is not suitable to treat your medical needs, he/she may indicate on the prescription that no substitutions are to be made. If this is indicated on the prescription, the pharmacy would be able to override the generic substitution for this drug and we would be able to consider the cost of the brand name medication.
Please note that this information is based on your eligibility as of the date of this message. If your coverage terminates, you may no longer be eligible for this type of expense.
Should you require further information or clarification, we encourage you to contact us through our Websites (www.sunlife.ca/pshcp or www.sunlife.ca/pdsp) or by telephone at 1-888-757-7427, Monday to Friday, 6:30 a.m. to 8 p.m. (ET).