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Introducing MemberRx as the exclusive distributor for certain specialty medications
Dear ETFO ELHT Plan Member,
The ETFO Employee Life and Health Trust (ETFO ELHT) recently designated MemberRx as the exclusive pharmacy distributor for certain high-cost specialty medications. This means that certain specialty drugs will only be covered under your ETFO ELHT benefits plan if they are dispensed to you by MemberRx.
This change will begin to take effect in June 2023.
What this means to you
You are only impacted by this change if you or your family member(s) are taking a specialty drug.
Specialty drugs are generally medications that cost more than $10,000 a year and require prior authorization. Only certain specialty drugs, the majority of which are currently being dispensed by pharmacies such as Bayshore, McKesson, Innomar and Bioscript, will be dispensed by MemberRx.
At this time, MemberRx is focused on providing certain specialty drugs. A list of the specialty drugs that will be initially distributed by MemberRx can be found here.
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If you or your eligible dependants are not currently taking one of the specialty drugs listed, you are not impacted by this change and no action is required.
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If you or your eligible dependants(s) require one of these specialty drugs in the future, your prescriptions will be sent directly to MemberRx through the FACET Prior Authorization program. This is similar to what already has happened in the past with Bayshore Pharmacy Services.
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If you or your eligible dependant(s) are currently taking one of the specialty drugs listed, you will receive a communication from OTIP with more information and details on how they will help you with the transfer of your existing prescription to MemberRx in the coming months. You can expect to receive this communication in the coming days.
NOTE: Specialty drug prescriptions will be transferred to MemberRx over several months starting in June. The transfer to MemberRx will not result in any change to medication, strength, dosage or cost. It will only be a change in the pharmacy providing the specialty medication.
Why MemberRx?
MemberRx is a collaboration between OTIP and Cubic Health, OTIP’s partner for the FACET Prior Authorization program. It is an innovative pharmacy focused on supporting the complex health needs of Ontario’s education community.
Through the MemberRx pharmacy model, expensive pharmacy and medication costs will be minimized which will help in supporting the sustainability of the ETFO ELHT benefits plan. Lower costs mean the ETFO ELHT can continue providing the best coverage for the medications plan members and their eligible family members need, at the best value.
How do I know if a drug that I am taking is impacted?
If you are not sure that a drug you or one of your dependants is taking is impacted by this change, please click here to access the drugs that will initially switch to MemberRx beginning in June 2023.
Questions about this email?
To learn more about MemberRx, visit www.memberrx.ca.
You can also visit the MemberRx FAQs available under My Resources in the OTIP plan member site.
To access contact information for OTIP, please log in to the OTIP plan member site at www.otip.com or contact OTIP Benefits Services at 1-866-783-6847.
Questions about this notice can be directed to the ETFO ELHT at inquiries@etfo-elht.ca.
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