With the Great-West Healthcare, now part of CIGNA, pharmacy program, drugs are categorized at three levels of coverage, so the member, doctor and 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.
1Dose optimization and step therapy do not apply to all drug plans.