The solution

The HealthWATCH® drug plan

The HealthWATCH® drug plan is a core component of your company’s overall health benefits package. The plan categorizes traditional drugs based on a combination of cost and efficacy of the drug, with a policy that supports the use of biosimilars.

Coverage decisions

The HealthWATCH® drug plan team, which includes pharmacists, leads the decision-making process, guided by the advice of a Clinical Advisory Board.

The Clinical Advisory Board considers medications according to:

Clinical
evidence

Impact on
employees

An economic and cost comparison

Overall impact on the drug plan

Ultimately, their goal is to use a plan member-first approach to find the right balance between drug plan affordability, and helping to keep employees healthy and at work.

The HealthWATCH® drug plan offers two levels of drug coverage, called "tiers":

Tier 1:
Higher coverage

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  • Includes most generics and some brand name drugs that are more cost-effective

Tier 2:
Lower coverage

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  • Includes some generics and brands (with or without generics) which the HealthWATCH® drug plan team has determined do not demonstrate additional clinical benefit relative to their cost, when compared to Tier 1 drug options that treat the same condition

Coverage based on tiers could save you up to

10%

on the cost of your drug plan costs

Not yet listed

not listed

Not yet listed

Some medications are not listed on either tier 1 or tier 2 because the plan already covers other more cost-effective drugs for the condition, or there are therapies available without a prescription.

Most employees will experience no changes. For those who do, there are options.

About 15% of employees may notice a change in the amount that they pay because they are currently taking drugs on Tier 2 or a drug that is not listed.

Options for affected plan members taking Tier 2 drugs:

  • Ask their pharmacist to work with their doctor, if necessary, to switch to a more cost-effective drug option on Tier 1 to get the highest level of coverage.

  • Continue to take Tier 2 drug, if that is their choice, and receive lower coverage.

Options for affected plan members taking a drug that is not listed:

  • Ask their pharmacist to work with their doctor, if necessary, to switch to another more cost-effective drug that could be on Tier 1 (higher coverage), Tier 2 (lower coverage) or even over the counter.

  • Continue to take the drug that is not listed. The member may have to pay a higher cost.

Our Drug Search tool lets plan members find out their drug coverage.

With our online Drug Search tool, plan members can search for their medication to understand coverage under the HealthWATCH® drug plan.

If their medication is on Tier 2 or Not Yet Listed, the Drug Search tool suggests Tier 1 alternatives that they can discuss with their healthcare professional.

Exclusive offers

Employees want more from their health plan.

Members of the HealthWATCH® drug plan get savings and exclusive offers!

Explore the offers
Exclusive offers