Under-65 spouses of seniors no longer qualify for drug plan

By GILLIAN SLADE on January 21, 2020.

gslade@medicinehatnews.com@MHNGillianSlade

The end of Blue Cross coverage for dependents of seniors has triggered official letters going out to all Albertans who are affected.

If you are not a senior but have a spouse who is, you have had coverage under your spouse’s plan. That will end on March 1.

“The Seniors Drug Program is for seniors – not for non-seniors. No other province covers non-seniors through a seniors drug program,” said Steve Buick, press secretary to the minster of health.

The rule changes for the Seniors Drug Benefit Program administered by Blue Cross was first announced last fall in the UCP budget. Mid-December media reports pegged the number of people that would be affected at 46,000 Albertans.

Of that, more than 8,000 range in age from 19 to 54, said Buick.

Several dependents of seniors have noted that even though they already have prescription coverage through an employer’s private plan, pharmacies typically charge the prescription first to Blue Cross and then to the dependent’s employer’s drug coverage plan.

Buick says this is not an error.

“Pharmacies have been billing appropriately. All provinces follow the Canadian Life and Health Association guideline for co-ordinating benefits. The government plan is always the first payer,” said Buick.

Some local residents have questioned whether simply changing the billing at pharmacies, so that private drug coverage pays for its members first, would save the provincial government enough money without cancelling coverage for all dependents.

“Changing the billing approach would have minimal impact because the majority of the dependents affected do not have multiple drug plans,” said Buick.

The government’s letter to all the dependents that are affected offers the option of purchasing Blue Cross coverage. The News has heard from some who were informed on the telephone that there is a waiting period of several months before it clicks in.

Buick says the government has made an exception for those affected in these particular circumstances.

“My department anticipated the concern about the three-month waiting period for Non-Group Coverage. It is being waived for any affected family members who apply before March 1,” said Buick.

Other government letters about Blue Cross coverage have been received by some seniors who, by virtue of their age, qualify for Blue Cross. They are not dependents.

According to the Blue Cross website when government contacts individuals, as they are approaching the age of 65, individuals may be asked to provide proof of age with a document such as a birth certificate.

The letters being sent out are instructing seniors, some who are now well over the age of 65, to provide proof of age or lose coverage on March 1.

Buick says in all of these cases, the individuals were originally requested to submit these materials when they turned 65 and some may have forgotten.

“The Albertans who are being asked to provide proof of their age were defaulted into the program before they became seniors. This was primarily individuals who initially joined the Coverage for Seniors plan as the younger spouse/partner/dependent of a senior,” said Tom McMillan, assistant director of communication for Alberta Health.

McMillan says as they were not yet 65 at the time, they were not required to submit proof of their age. A few months before turning 65, they would have been sent a letter asking them to provide the appropriate documents. Many did so. Those who did not are now being asked to provide those materials.

According to Buick the seniors drug program costs $600 million a year and that cost is increasing at about eight per cent a year. The change in coverage will save $36.5 million annually.

Anyone with questions or concerns can reach the Alberta Health Care Insurance Plan office by phoning 780-427-1432 (toll free in Alberta by first dialing 310-0000).

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