Alberta Blue Cross®'s prescription drug plans are designed to maintain affordability while maximizing efficiency, flexibility and convenience.
Prescription drug options
We offer prescription drug coverage at various co‐payment levels from 70% to 100%. Choose either pay direct or reimbursement claims payments.
Direct bill: With direct bill, your employees pay only their portion of the prescription cost and the remainder is billed to us directly from the pharmacy.
Reimbursement: With reimbursement, employees pay the full cost of the prescription up front then submit a claim to receive payment.
Technological leader
We have been the leader in electronic claim processing for over a decade and own and manage our pharmacy claims network. Adjudication of your claim takes only seconds. Plus, pharmacists can access information on patient coverage, benefit eligibility, applicable benefit caps, benefit restriction, deductibles or maximums to allow on‐the‐spot handling.
Our system also includes Drug‐to‐Drug Interaction Screening which automatically screens all direct‐bill prescription drug claims for possible interactions with previously dispensed prescriptions. This tool can protect your health and the health of your employees.
Expert approaches
Our Clinical Drug Services department includes pharmacists who can provide clinical expertise for members taking certain high-cost drugs. They provide education on the member’s medication, condition, and help navigate drug coverage.
Adding value
Drug plan management at Alberta Blue Cross starts with a solid unique foundation built on systems and management processes that benefit all our drug plans. These include:
- a comprehensive drug review process, where each new drug is thoroughly reviewed in-house before a listing decision is rendered,
- extensive management of drug prices to ensure our plans are not paying excessive drug costs,
- negotiating product listing agreements with drug manufacturers for various drugs to maintain drug plan affordability and sustainability, and
- monitoring the drug environment and adapting our listing strategies to ensure continued optimal management and savings for our drug plans.
Further customize your plan with the option of adding:
- an annual maximum (available from $1,000 to $5,000),
- a dispensing fee cap or per prescription deductible,
- and ensure your plan only pays up to the cost of the generic medication by choosing to apply mandatory generic substitution.