An Ottawa family is facing a difficult battle with their health insurance provider after being denied coverage for a crucial prescription medication for their chronically ill daughter. Julie Jewett, a federal public servant, says she is "running out of options" after her insurance plan refused to pay for a doctor-prescribed weight-loss drug because it is not formally approved for children under 12.
A Mother's Fight for Her Daughter's Health
The situation came to light on January 14, 2026, when the family's story was first reported. Julie Jewett's daughter lives with a chronic health condition where managing her weight is a critical component of her overall care and treatment plan. Her physician determined that a specific weight-loss medication was medically necessary. However, the family's health insurance plan, provided through the public service, denied the claim.
The denial was not based on a lack of medical need, but on a technicality: the drug in question is not officially approved by Health Canada for use in children under the age of 12. This leaves families like the Jewetts in a difficult position, caught between a doctor's prescription and an insurer's policy restrictions.
The Coverage Gap for Pediatric Medications
This case underscores a broader issue within Canadian drug coverage plans, particularly for children with complex or rare conditions. Many medications are prescribed "off-label," meaning they are used to treat conditions or age groups outside their initial approval. This is a common and legal practice in medicine, but it often becomes a stumbling block for insurance coverage.
Julie Jewett now faces the prospect of paying for the expensive medication out-of-pocket, a financial burden that many families cannot sustain. "We feel like we're hitting a wall," she stated, emphasizing that the drug is not a choice but a part of her daughter's prescribed medical regimen. The family's experience raises questions about the flexibility of public service health plans and whether they adequately serve employees with dependents who have serious health needs.
Broader Implications and Seeking Solutions
The Jewett family's struggle is not an isolated incident. Advocates for patients with chronic illnesses often point to rigid insurance formularies and approval processes as significant barriers to care. When a treating physician deems a drug necessary, the conflict with an insurer's checklist can delay or deny vital treatment.
This denial comes at a time when discussions about pharmacare and universal drug coverage are prominent in Canadian politics. Stories like this one highlight the very real human cost of coverage gaps and bureaucratic hurdles. For now, Julie Jewett continues to advocate for her daughter, hoping for a review or exception to the rule, while also considering appeals and other avenues to secure the medication her child's doctor has recommended.
The outcome of this case could have implications for how public and private insurers in Canada handle off-label prescriptions for pediatric patients, potentially prompting calls for more nuanced and compassionate review processes.
