How the plan works
How it works
Your HealthWATCH® / PharmEXPERT Drug Plan is simple, with an employee-first approach that finds the right balance between affordability and keeping people healthy and at work.
There are two levels of coverage or reimbursement, called “Tiers” which are determined by factors including the cost of the drug, how it compares to others for the same treatment, the drug availability, its clinical effectiveness, delivery, and storage. Coverage available depends on the tier your prescription falls under, and together, they cover the majority of traditional prescription drugs used to treat common conditions.
Tier 1: Higher coverage
Tier 1 drugs include most generic prescription drugs and some brand name drugs that are more cost-effective than the generic version. Higher coverage means your reimbursement amount will be higher.
Tier 2: Lower coverage
Tier 2 drugs include some generics and brand names our team determined do not demonstrate additional clinical benefit relative to their cost, when compared to Tier 1 options that treat the same condition. Lower coverage means your reimbursement amount will be lower.
These are drugs that have more cost-effective alternatives on a Tier 1 or 2 plan that treat the same condition, or have therapies are available over-the-counter instead.
Search your coverage
Use our online Drug Search tool to find out the level of coverage for your medications, or if they’re not listed, you’ll see the alternatives, if available, so you can get the highest level of coverage. Your pharmacy can help you learn more about your options. You’ll need your employee number to access the database.Search now
*Most prescription drugs are "traditional". They treat a wide range of common illnesses or conditions like diabetes, high blood pressure, and high cholesterol.
*In Quebec any pharmacist consultation will be the responsibility of the pharmacist-owner chosen by the user.