Prescription drug expenses claim form
Bought Freedom to Choose™ health and dental insurance coverage directly through Canada Life? You’re in the right place.
If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms. If you have coverage through an advisor, use our personal insurance forms.
Submit your claim online
Your online account makes it easy to submit your claims online or print forms that are pre-filled with your personal information.
Start a paper claim
Use this form to request reimbursement for prescription drug expenses covered by your plan. You'll find instructions on how to return the completed form on the form itself.
Standard claim form
Download this form and print it, or fill it out in Adobe Reader XI or higherOpens a new website in a new window - Opens in a new window (not your browser) and save.
Use this form to claim expenses relating to medical or vision treatment and prescription drugs. You'll need itemized receipts for some sections.