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Have you been prescribed a medication that requires approval (special authorization) from the drug plan before it can be covered?

Yes

If yes, your prescriber is required to submit a Special Authorization request on your behalf to the government before the drug plan can make a decision about whether it will be covered for you. The Interactive Drug Benefit List (iDBL) outlines what the coverage is and whether it requires a special authorization or not. You can look up the prescribed medication to see if it requires special authorization or you can speak with your healthcare provider for more information.

If the Special Authorization request is approved, then the medicine would be covered for you in the same way as a regular formulary benefit is managed.

If the product is denied, the decision can be appealed by you or your health care provider.

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