Alberta Blue Cross's prescription drug plans are designed to maintain affordability while maximizing efficiency, flexibility and convenience. Last year alone we processed over 31.7 million prescription drug claims.
Prescription drug options
We offer prescription drug coverage at various co‐payment levels including 100%, 80%, 70%. Choose either pay direct or reimbursement claims payments.
- Direct bill: With direct bill, your employees pay only their portion of the prescription cost and the remainder is billed to us directly from the pharmacy.
- Reimbursement: With reimbursement, employees pay the full cost of the prescription up front then submit a claim form with their receipt for payment.
We have been the leader in electronic claim processing for over a decade and own and manage our pharmacy network. Adjudication of your claim takes only seconds, the best response time in the industry. Plus, pharmacists can access information on patient coverage, benefit eligibility, applicable benefit caps, benefit restriction, deductibles or maximums to allow on‐the‐spot handling.
Our system also includes Drug‐to‐Drug Interaction Screening which automatically screens all direct‐bill prescription drug claims for possible interactions with previously dispensed prescriptions. This tool can protect your health and the health of your employees.
Our Clinical Drug Services and Evaluation department includes pharmacists who provide clinical expertise on special authorizations, drug interaction and compliance.
Licensed pharmacists, pharmacy technicians, nurses, a medical consultant and other staff provide drug plan utilization reviews, drug information and educational presentations. As well, our provider relations team conducts pharmacy audits to prevent claim abuse, fraud and improper billing practices.
Our pharmacy pricing agreements guarantee you and your employees the lowest dispensing fees available.
At the same time, a Least Cost Alternative (LCA) price policy makes it possible for you to reduce plan premiums while still maintaining quality prescription drug coverage. LCA pricing is a sound approach to decreasing the cost of claims by using the lowest priced interchangeable products.