The Government of Alberta, the Alberta Pharmacists’ Association and Alberta Blue Cross recently approved the new Pharmaceutical Services Provider Agreement. This agreement provides additional support to pharmacies in offering services that will provide better access to health services for Albertans. It also outlines a number of important changes for pharmacies across the province and how prescription costs are calculated.
While a number of the changes presented in the new agreement will not affect the ASEBP Benefit Plan directly, there are a few that have the potential to greatly impact the plan. While we are still in the process of analyzing how the agreement will affect us, the first change to take effect for ASEBP’s Extended Health Care (EHC) Plan concerns prescription medication dispensing fee maximums.
Starting April 1, 2014—when the new agreement comes into effect— ASEBP will be moving to a flat rate system which will result in a dispensing fee maximum of $9.00 for drugs including purchased compounds and $13.50 for compounds mixed by the pharmacist in-store. This will ensure ASEBP is aligned with the new provincial agreement which has moved to a flat dispensing fee system. You can find more information on this, including definitions of purchased compounds and compounds on our EHC Plan Descriptions page.
What does this new agreement mean for me?
Depending on the particular prescription medication that a covered member is getting filled, some may find they are incurring higher out-of-pocket expenses when the changes go into effect, while others may find they are paying less. ASEBP expects that most covered members will not notice a significant difference.
As mentioned, we continue to analyze the Pharmaceutical Services Provider Agreement and expect there will be additional adjustments to the ASEBP EHC Plan in light of the changes the agreement enacts. We will share any further changes with covered members accordingly. It’s important to note that all benefit providers in Alberta are also affected by changes to new costing for drug ingredients and pharmacy upcharges under the new Pharmaceutical Services Provider Agreement. If you would like to learn more about what makes up a prescription, check out the article of the same name in the Rx Benefits section of our website.
Updated: May 7, 2014