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DrugBenefit Home Page SOME COMMON QUESTIONS
WHAT DOES "Calculated" COPAY ON MY CARD MEAN? This means that although you pay the full cost of your prescription directly to the pharmacy, SPC's processor calculates the amount electronically. Your calculated price includes a network discount off the cost of the drug and the pharmacist's dispensing fee. This negotiated "calculated" price is generally much lower than the pharmacy's regular price.
The pharmacist should submit the regular price to the processor. The processor allows only the lower of his regular price or the negotiated price. (It is not uncommon for some stores to advertise "loss leader drugs" - drugs that they are willing to lose money on to encourage customers to come to their pharmacy.) If your drug is advertised at a lower price than the negotiated price the pharmacist should submit the advertised price to the processor. Do not allow yourself to be penalized because your prescription is being processed! Remember - your prescription must be transmitted to the processor so it can perform necessary safety checks against your drug profile. HOW CAN I TELL IF MY PRESCRIPTION HAS BEEN TRANSMITTED? A prescription that has been electronically processed should have a "Claim Reference Number" printed on your receipt or label. Always check for this number. This way you can be assured that you have received the lowest price and that your medication has been checked against your central profile for interactions or other problems. WHAT PHARMACY CAN I GO TO? This plan recognizes Any Willing Pharmacy Provider. Any pharmacy that agrees to meet the plan's conditions and electronically submit your prescription can fill it for you. Thousands of pharmacies across the USA have already agreed to do this. However, if your personal pharmacy is not a member of this network, the pharmacist can call the toll-free number on your membership card and immediately arrange to process your prescriptions.
Pharmacy is an increasingly competitive business - as is all of health care. However, some pharmacies may not wish to compete in today's environment - or they may feel that they do not need to. This plan gives any qualified pharmacy desiring to participate the opportunity to do so. If you wish to take advantage of your plan and its benefits, you will need to go to a participating network pharmacy. This may require that you use a new pharmacy. Fortunately there are many who will value you as a customer – almost 40,000 stores. Remember, a decision not to participate is that of the individual pharmacy, not the plan.
Yes. The pharmacist at the store you wish to transfer your prescription to can usually do this for you. WHAT PRESCRIPTION QUANTITY CAN I GET? This is determined by your physician. This plan does not limit quantities. Generally, you will get a better price at the pharmacy for larger amounts, and the maximum-allowed 90-day supply is your most cost-effective quantity for Canadian purchases via the Expedite-Rx technological interface. If yours is a maintenance drug (one that you will be taking for a long time) you will want to ask your doctor to prescribe the most economical amount that is safe for you. Many factors determine the quantity of drug to prescribe - you should discuss these with your doctor. WHY GET MY GENERICALLY-AVAILABLE PRESCRIPTIONS IN THE LOCAL RETAIL PHARMACY NETWORK? The Expedite-Rx technological interface aspect of your benefit concentrates on saving you money on your most expensive brand name medications from the Canadian Pharmacy. Mail-order pharmacies, whether Canadian or the traditional US types, cannot supply generic drugs that are available in the US at a cost that is competitive with your local network pharmacies when you use your benefit card.
To help protect your billing and personal health information. Due to increased danger of transmitting personal information via the internet, the DrugBenefit enrollment forms are designed to be printed, completed and then faxed or mailed to the DrugBenefit home office. Even with a secure website many folks are skeptical to imput personal and billing information and transmit to cyberspace. |
