New Pharmacare coverage now in effect
Health Science Professional members of HSA are reminded that changes to extended health benefits coverage took effect on June 1st with the implementation of PharmaCare Tie-In. As part of these changes, all HSP members should by now have received a BlueNet card. The BlueNet card direct-pay of eligible prescriptions when picking them up at the pharmacy instead of paying up front then submitting receipts for reimbursement.
If you have not yet received your BlueNet card, please let us know immediately by contacting @email.
Under these new PharmaCare Tie-In rules, the cost of medication is covered only if it is included on an approved list known as the formulary. If the medication you are prescribed is not on the Pharmacare formulary, then your pharmacist will likely suggest a generic alternative which is covered for reimbursement, or you may consult your doctor and ask to be prescribed an equivalent medication that is covered. Alternatively, brand name medications may be eligible for partial coverage which means that you would pay the difference between the cost of the generic equivalent listed on the formulary and the price of the brand name medication. This is known as Low Cost Alternative pricing and is the same language set out in the previous collective agreement.
You can find out more about the Pharmacare Tie-In on the Pacific Blue Cross web site: http://www.pac.bluecross.ca/hsp/. This webpage, designed specifically for HSP members, provides information about the 90 day grace period and the reimbursement process for members who incur eligible prescription costs during this grace period. In addition, there are links to Frequently Asked Questions and the Special Authority process.
HSA understands that the transition to Pharmacare Tie-In may be difficult in some cases, and we have worked to establish and then extend a grace period to allow members on maintenance medication protocols for chronic medical conditions to work with their treating physicians to ensure the transition is as smooth as possible. The grace period will expire on August 31, 2013. Members are reminded to contact their care providers as soon as possible to alert them to this change and initiate the Special Authority process where necessary.
HSA is here to help you through this process -- if you have had your Special Authority request denied, or if you have not yet received your BlueNet card, please let us know immediately by contacting @email.