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Prior authorization forms

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Find a prior authorization form

Some prescription drug claims need to be approved before you can apply for reimbursement. To do that, we’ll need information from you and your doctor about your plan, your condition, and what you’re being prescribed. 

You can read more about the process in General information for prior authorization drugs | PDF – 1.2MbOpens in a new window - Opens in a new window.

To find out whether your group benefits plan covers the drug you’re being prescribed, log in to GroupNetOpens a new website in a new window - Opens in a new window. If your prescription is covered, then you can follow these steps:

  1. Find the form you need on this page.
  2. Print the form and complete the plan member sections. You can also download it and fill it out in Adobe Reader (not your browser).

  3. Ask your attending physician to complete their sections.

  4. Send the completed form to us by mail, fax or email. Each form will include addresses and instructions.

Not the forms you're looking for? Go back to the find a form page.