Effective April 1, 2025, the copay for a limited number of eligible prescription drugs will change.

What is a copay?

Copay refers to an individual’s out of pocket expense for a claim.

For the large majority of drug claims under Memorial University’s plan, the copay is equal to the dispensing fee plus any pharmacy markup. The remainder of the cost of a prescription is covered by the university’s group insurance plan. Effective April 1, 2025, this will change for a limited number of drugs and the copay will increase. To mitigate against any out-of-pocket expenses, these drugs are eligible for third-party patient support programs and you will need to apply.

Eligible drugs must be:

1. high cost ($10,000 or higher)
2. used to treat complex chronic or life-threatening conditions such as cardiac, rheumatoid arthritis, cancer, multiple sclerosis or hepatitis c; and
3. prescribed by a specialist

Impacted claimants will be notified directly by Medavie Blue Cross and provided instructions on how to avail of the financial support. For the transition to specialty select, impacted claimants will have until June 30, 2025, to complete any documentation required. For those who complete the documentation after this date, their out-of-pocket expense may be increased until they complete the documentation.

Why make this change?

Health expenses continue to rise as both utilization and costs increase. Ensuring the financial stability and longevity of the plan is always a consideration with the management of the plan. Changing this copay amount will equal savings not only for impacted claimants, but for Memorial’s claims experience. With a lesser amount being reimbursed by the plan, costs will increase at a slower rate. Making this change allows for cost savings without reducing benefits available. Memorial’s goal is always to offer a competitive and sustainable benefits package for employees and retirees.