Pharmacy Program Advantages

Your pharmacy benefits are administered through the Health Advantage Pharmacy Program, which eliminates paper claim forms and employs the latest technology for electronic pharmacy claims processing. When you fill your prescription at a participating pharmacy, the Pharmacy Program computer network instantly alerts the pharmacist to the following:

• Any potential harmful interaction of the medication about to be dispensed with any other medication that the patient may already be taking;
  
  
• Whether this medication may duplicate another medication the patient is taking;
  
  
• Whether the prescribed dosage or strength is appropriate for the age of the patient.
  
  

These features help you save money and promote good health and safety.

Three-Tier Medications Formulary

The Three-Tier Formulary (2894 KB PDF) The specific dollar amount of copayment for each medication will vary depending upon your policy benefits, but the tier assignment for the medication will be the same for all members. Look on your health-plan ID card or drug card to determine the dollar amounts of your copayments. In general, the three copayment levels are:

First tier: Almost all generic medications (lowest copayment of all tiers).

Second tier: Preferred brand-name medications and other lower-cost, brand-name medications (mid-level copayment).

Third tier: High-cost medications or medications classified as nonpreferred (highest level of copayment).

Pharmacy and Therapeutics Committee

The Pharmacy and Therapeutics Committee makes recommendations regarding preferred and nonpreferred medications. The committee includes:

• Arkansas physicians in private practice;
• Medical directors from Arkansas Blue Cross and Blue Shield and Health Advantage;
• Community pharmacists in private practice;
• Pharmacy directors of major Arkansas hospitals;
• Arkansas Blue Cross/Health Advantage pharmacy director.

For More Information

If you need more information about your prescription drug coverage, call: