What is Rx Choices? - Medavie Blue Cross

BRO-144E 05/14
at 1-888-873-9200.
or call our contact centre
The drugs selected for the Second Tier may not be
the first step in therapy, are generally for less serious
medical conditions and/or have lower cost
therapeutic alternatives on the First Tier.
please e-mail us at
Second Tier (higher co-pay)
[email protected]
Rx Choices
empowers you,
in consultation
with your
doctor, to
determine
your best
treatment
options. By
making smart
consumer choices
regarding medication
therapy you ensure your
co-pay and contributions to your
employee health plan remain affordable.
TM
Helping you and your physician
make better, more affordable choices.
The medications selected for the
First Tier are recognized as first-line
therapy, used to care for serious
medical conditions and generally more
cost effective. This tier includes many generic
and brand name products. Medications on this
tier follow widely accepted treatment guidelines
for many acute and chronic conditions.
a product is on,
Being a wise consumer should also extend to
your health products and services. Would you
pay more for a medication if you knew a
lower cost alternative existed?
First Tier (lower co-pay)
To confirm which tier
Every day
we make wise decisions
when it comes to our finances. From buying a
preferred brand at the grocery store to choosing
an affordable contractor when renovating our
home, the quality of product along with its
value often determines our choice as an
educated consumer.
The first tier includes most generic and many
brand name products and patients pay a
lower out-of-pocket amount.
Medications are separated into two tiers, and the
co-pay varies between the tiers.
• used to care for serious medical conditions
• recognized as first-line therapy
• generally the most cost effective option
offers coverage for many medications.
Medications selected for the First Tier are;
Rx Choices is a unique tiered benefit listing that
Rx Choices is a unique tiered benefit listing that offers
coverage for many medications. Medications are separated
into two tiers and the co-pay varies between the tiers.
What is Rx Choices?
The following is a list of
frequently prescribed
medications found on Tier 2.
This list is not all-inclusive and
is reviewed on an ongoing basis.
For most of these items more
affordable first-line therapy
alternatives are available on the
first tier.
Note: Some medications covered under this
plan require special authorization.
First-line therapy: A drug or class of drugs
that would be tried to
treat a particular disease
condition.
Birth Control
• Evra
• Micronor
• Tri-cyclen
• Products indicated for acne
• Yaz
Blood Pressure
• Atacand
• Avalide
• Avapro
• Cozaar
• Diovan
• Hyzaar
• Micardis
• Olmetec Plus
• Rasilez
Cholesterol
• Ezetrol
• Lodalis*
Depression
• Cipralex
• Zyprexa Zydis
Dental
• Oracort
Diabetes
• Amaryl
• Glucobay
• Victoza
Co-pay: The amount you pay for
prescribed medications.
It is the difference
between the total cost
of the medication and
the portion paid by
your health plan.
Updated April 2014
Hemorrhoidal preparations
Migraine Therapy
• Amerge
• Axert
• Frova
• Relpax
Nausea
• Malarone Tab
Osteoporosis
• Evista
Parkinsons
• Mirapex
• Requip
• Stalevo
Sedative
• Imovane
Topical Ointment
• Dovobet*
• Silkis*
Estrogen
• Estring Vaginal Ring
• Climara Patch
• Estrogel Transdermal Gel
• Estradot Transdermal Patch
Gastrointestinal
• Dexilant*
• Nexium
• Tecta
Gout
• Uloric*
Terms for Reference
*Only Eligible if mandated by provincial legislation.
Acne
• Most topical and oral acne products
ADHD/Narcolepsy
• Adderall XR
• Biphentin
• Concerta Extended Release
• Strattera
Allergies
• Avamys
• Flonase
• Nasonex
• Omnaris
Anti-fungal
• Ketoderm Cream 2%
• Lamisil
• Loprox
• Nystatin
• Penlac Sol’n
• Stieprox 1.5% Shampoo
Anti-Inflammatory
• Celebrex
• Vimovo
Antimalarials
Antipsychotics
• Invega
Anti-virals
• Famvir
• Tamiflu*
• Valtrex
You can also send an e-mail to
[email protected] or call our
customer contact centre at 1-888-873-9200
for assistance in determining which tier a
medication appears.
Benign Prostatic Hypersplasia
• Rapoflo*
Attached is a wallet card we encourage
you to take with you to your physician.
This card describes the types of
medications included on each tier, as
well as a list of examples of the second
tier medications.
TIER 2 DRUG LISTING
How will I know what
medication is included
in which tier?
Rx Choices empowers you to ask questions
around your treatment options. When meeting
with your physician, they will ultimately
determine what treatment option is best,
but sometimes when treatment
options are similar, cost can
be the difference.
Most of the medications covered under your
Rx Choices drug benefit plan are included in
the First Tier. For those medications included in
the Second Tier, the co-pay will be higher.
Why should I be
concerned about the cost
of my treatment?
How much will I pay
for my prescriptions?
Tier: A layer or level.