A couple of weeks ago some of us who are Health Alliance HMO members received a letter stating that "Health Alliance is pleased to announce an improved pharmacy benefit program with more emphasis on value and choice. Your health plan administrator has approved a new three-tier pharmacy copayment benefit effective July 1, 1999."
The "improved benefit" is an increase in prescription prices for some drugs. At present, we pay a $5 copayment for all prescribed drugs purchased at authorized pharmacies. But starting July 1, the copayment will depend on which drug you buy. Copayments for generic drugs and "preferred name-brand drugs" will remain at $5, but if your drug is not "preferred" by Health Alliance, your copayment increases to $25. Six hundred medications are on the "preferred" list, but Health Alliance members are not allowed to see the list.
PersonalCare, the Covenant Hospital/Christie Clinic HMO, has adopted a similar tier payment system for prescription drugs. PersonalCare offers fewer "preferred" drugs (about 400), but PersonalCare will let you see the list of medications. For whom is this an "improved" benefit program? Are these the kind of choices that we are seeking in our health plan? What do we gain, if anything, from this change?
Increasing insurance premiums takes money away from academic professionals. If academic professionals were part of a recognized collective bargaining unit, we could have a voice in negotiating such changes with the administration. Without a union, the administration decides on their own. Join the Association of Academic Professionals to protect your pay and your benefits.