List of all drugs that may be classified as “Requires Special Authorization” by the plan sponsor under our Managed Plans, including specialty medication.
List of Specialty drugs only. These drugs may be classified as “Requires Special Authorization” by the plan sponsor – plan members may download this list and provide it to their Healthcare Providers.
This claim form should be completed when an individual whose plan design includes mandatory generic is applying for coverage for the full cost of the brand name drug.
This form is to be completed when an individual is accessing the coverage navigation service for assistance applying to government and/or manufacturer sponsored programs for Specialty Drug coverage.