Exceptions
We understand that sometimes taking an
alternative medication to what your physician
has prescribed is not always possible. Whether
it’s because of medical reasons such as allergies
or medication shortages, if you’re unable to take
or access the preferred or reference medication
used in our medication management programs,
you have options.
If you’re allergic to any of the ingredients found
in the preferred medications used in our TARP
program or another medical reason prevents
you from taking it, your physician can complete
a special authorization form to request coverage
for the medication they have prescribed — your
physician has access to this form, so you do not
need to provide it to them. Please note that there
must be medical documentation to support this
exception and simply requesting it does not
guarantee approval.
If you are unable to access the LCA or
preferred medication due to a known
medication shortage — which can and does
happen — ARTA will assess the situation and
may temporarily suspend LCA and TARP
programs for the affected medication category.
During medication shortages, especially those
that result in a need to change your regular
medication, we encourage you to work directly
with your physician or pharmacist to manage
how the shortage affects you and the best course
of action for your health. Please do not try to
obtain medications through online sources or
by travelling to other countries who may have
supply — your ARTA benefits may not cover
associated costs.
Safety
While these programs are in place to benefit
our members, we understand there may be
some hesitation when it comes to ‘generic’
medication. When people hear LCA, TARP, or
generic medications, they sometimes believe
these drugs aren’t as effective as their higher cost
counterparts. Rest assured that all of the generic
and preferred medications ARTA references in its
programs have the same level of quality, safety,
and performance as the higher cost medications.
At the end of the day, our main goal is to
ensure that you and your dependants have access
to the medications you need, when you need
them — now and in the future. Our medication
management programs allow us to reduce the
risk medication costs pose to the plan without
compromising fair and equitable access to
prescription coverage for all ARTA
plan members.
If you have questions about the medication
you’ve been prescribed or the one your pharmacist
is recommending based on our programs, please
speak with your health-care provider. ●
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