If yes, your prescriber is required to submit a special request on your behalf for determination by the government before it can be covered. In some cases, your prescriber may be exempted from prior authorization requirements – check with your prescriber to see if this is the case for her / him.
If the special authority request is approved, then the medicine would be covered for you in the same way as a regular formulary benefit is managed.
If the special authority request is denied, then it would not be covered by the public plan. Any money you spend on this medicine would not be counted towards the calculation of your deductible or any prescription cost-sharing.
A private health plan may still provide coverage towards these medicines. Please click here to learn more.
