With the Great-West Healthcare pharmacy program, drugs are categorized at 3 levels of coverage, so the member, her doctor and her pharmacist select the right drug for her specific needs and budget. Member out-of-pocket prescription costs depend on the tier from which the medication is selected:
- Tier I Generic drugs: Lowest cost; same quality and effectiveness as the brand-name drug
- Tier II Preferred brand-name drugs: More expensive than a generic; equally effective as, but usually less expensive than, non-preferred brand-name drugs
- Tier III Non-preferred brand-name drugs: Most expensive, so the member's share of the cost is also higher
Members can access prescription benefit details, prescription history, formulary lists, drug price check, a pharmacy locator and additional prescription information via the "Prescriptions" tab on MyGreatWest.com (registration required).
Additional pharmacy program components include:
- 90-day retail program: Allows members to pick up a 90-day supply of maintenance drugs for a 60-day supply copay
- Managed drug limitation program: Ensures safe use of certain drugs
- Prior authorization program to monitor high-cost drugs
- Specialty pharmacy network: Delivers medication that requires special handling
- Dose optimization program1: Simplifies drug routine by identifying when it’s possible to replace multiple doses of a lower-strength medication with a single dose of a higher-strength medication, with a doctor’s approval.
- Step therapy program1: Helps determine the most cost-effective medication by requiring members to try certain medications first (e.g., less costly prescriptions) before receiving a higher-cost medication.
1 Dose optimization and step therapy do not apply to all drug plans.