January 1, 2022 – January 31, 2023

As we have implemented the ARTARx and ARTARx+Travel benefit plans, you may be eager to get all your prescriptions transferred to the new pharmacy. There is no rush to do so, and in fact, you cannot take any action on prescription transfers until the pharmacy receives its initial inventory.

ARTA is implementing a transition period for members enrolling in the ARTARx plans, effective January 1, 2022, to January 31, 2023. During this time, you will be covered for 100% of all eligible medication claims and 80% of lifestyle medications, regardless of the pharmacy you use.

This means that until February 1, 2023, you can continue to use your current pharmacy while still enjoying the full benefits of your ARTARx plan coverage.

Medications requiring special authorization will continue to require special authorization, and medications not eligible under ARTA’s Drug Benefit List will remain ineligible.

At the end of the transfer period on February 1, 2023, the full ARTARx benefit plan design will be implemented. One of the key features of the ARTARx plan design was additional coverage for medications found on the Chronic Drug List when filling those medications at the ARTARx pharmacy. The following conditions are included as part of this plan design:

  • Medications identified on the Chronic Drug List will be subject to a maximum of 50% coverage of the eligible amount when dispensed by a pharmacy other than the ARTARx
  • Medications not included on the Chronic Drug List are subject to a maximum of 80% coverage of the eligible amount when dispensed outside of the ARTARx

For example, after the transition period ends on January 31, 2023, if you fill a prescription for the medication of a chronic or acute condition, you will be covered for a different amount depending on where the prescription is filled.

  1. Filling a chronic use medication – atorvastatin, metformin, pantoprazole, ramipril are all common examples.
    1. If filled at ARTARx, you will have 100% coverage*
    2. If filled at another pharmacy, you will have a maximum of 50% coverage*
    3. Coordinated claim through a primary plan (Alberta Seniors Plan, or a private plans), the ARTARx plan won’t offer any additional coverage over the 50% eligible cost.
  2. Filling a lifestyle medication – prescription hair loss, erectile dysfunction, and weight management medications approved by Health Canada
    1. Filled at 80% coverage, regardless of pharmacy provider*
  3. Filling an acute medication – topical rash creams, antibiotics, short-term pain medications
    1. If filled at ARTARx, you will have 100% coverage*
    2. If filled at another pharmacy, you will have 80% coverage* (this is the same coverage level currently offered by the other ARTA health plans)

 *all coverage is subject to plan annual maximums

This set-up is designed to encourage members to fill their chronic-use medications through the ARTARx pharmacy, while giving flexibility to obtain acute medications elsewhere, at the same coverage level as other ARTA plans. As chronic medications are for long-term use in the management of ongoing conditions, scheduling of refills ensures members are never without supply.

Want more information? View our list of Frequently Asked Questions!

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