Special Authorization

For over 20 years our Special Authorization process, led by a team of on-staff nurses and health care workers, has ensured that plan members have access to benefits that may otherwise have been restricted by cost.

Our Special Authorization criteria is guided by the health care professionals on our Medication Advisory Panel, which reviews medications and classifies them as needing prior approval, where a set of clinical criteria must be met before the prescription is eligible for reimbursement.

We make sure the prescribed drugs are safe and effective and are being used for conditions the government and the manufacturer have approved.

This approach ensures the patient receives the treatment they need, and the plan spends smart money on a proven safe and effective treatment.