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Pharmacy Benefits
Find a Provider 		Your 2007 Prescription Drug Benefit
Health Alliance HMO members receive their pharmacy benefits through Health Alliance. Copayments for a 30-day supply of prescription drugs are as follows:
  • If you receive a Tier 1 drug, you pay a $10 copayment.
  • If you receive a Tier 2 drug from the preferred list (when no Tier 1 drug is available), you pay a $20 copayment.*
  • If you receive a Tier 3 drug that is not from the preferred list (when no Tier 1 drug is available), you pay a $40 copayment.
To help physicians in prescribing for their Health Alliance HMO patients, Health Alliance has created a list of outpatient prescription drugs that provide both therapeutically effective and cost-effective treatment. This list of more than 600 preferred drugs is maintained by a committee of physicians and pharmacists who carefully evaluate the many alternatives available on the market. To keep your costs as low as possible, we ask that you and your physician work from this list in choosing your medicines. In some rare cases, your doctor may believe only a Tier 3 drug is appropriate treatment. If the doctor submits a request for a medical exception review to Health Alliance and it is approved, you pay only the $20 copayment.

* If a generic is available, you pay the $10 Tier 1 copayment plus the difference between the retail cost of the Tier 2 drug and the Tier 1 drug.

If you would like to view the Health Alliance HMO standard drug list, click here.

Health Alliance Illinois members receive their pharmacy benefits through MedCo. If you would like information about Health Alliance Illinois pharmacy coverage, click here.
 


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All contents © 2007 Health Alliance Medical Plans. All rights reserved. Every effort has been made to ensure that this information is accurate. It is not intended to replace the legal source. In case of any discrepancy between this information and the legal source, the legal source will govern in all cases.

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