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Drug prior authorization

Need to get prior authorization for a drug? Give us a call.

Before you get started

Understand your drug coverage

Drug coverage can vary depending on your plan or home province. Also, some drugs are excluded from our plans or require prior authorization.

If you're covered by a provincial health plan, submit your claim to that plan first as it may cover the drug. If your claim is denied, submit a copy of the denial with our request form.

See excluded drugs and products

We do not reimburse the drugs and products listed below. Note that the list may be changed without notice and certain plans may exclude other drugs that are not on the list.

For more information, see your insurance booklet.

Excluded drugs and products

Abecma (idecabtagene vicleucel)

Alhemo (concizumab)

Amvuttra (vutrisiran)

Avastin (bevacizumab) and biosimilars

Balversa (edafitinib)

Berinert (C1 esterase inhibitor)

Besponsa (inotuzumab ozogamicin)

Beqvez (fidanacogene elaparvovec)

Brineura (cerliponase alfa)

Bylvay (odevixibat)

Cablivi (caplacizumab)

Cerdelga (eliglustat)

Dacogen (decitabine)

Darzalex (daratumumab)

Demylocan (décitabine)

Diacetylmorphine Hydrochloride (diamorphine HCL)

Elrexfio (elranatamab)

Enhertu (trastuzumab deruxtecan)

Epidiolex (cannabidiol)

Evkeeza (evinacumab)

Eylea HD (aflibercept)

Finlius (ustekinumab)

Gavreto (pralsetinib)

Haegarda (C1 esterase inhibitor)

Hemgenix (etranacogene dezaparvovec)

Herceptin (trastuzumab) and biosimilars

Idhifa (enasidenib)

Im​c​ivree (setmelanotide)

Imfinzi (durvalumab)

Imjudo (tremelimumab)

Inqovi (decitabine-cedazuridine)

Jemperli (dostarlimab)

Keytruda (pembrolizumab)

Korsuva (difelikefalin)

Koselugo(selumetinib)

Lartruvo (olaratumab)

Libtayo (cemiplimab-rwlc)

Livmarli (maralixibat)

Liftulo (ritlecitinib)

Lumakras (sotorasib)

MDK-Nitisinone (nitisinone)

Minjuvi (tafasitamab)

Mounjaro (tirzepatide)

Myalepta (metreleptin)

Nerlynx (neratinib)

Nexviazyme (avalglucosidase alfa)

Nitisinone (nitisinone)

Opdivo (nivolumab)

Optune device

Orfadin (nitisinone)

Orladeyo (berotralstat)

Orgovyx (relugolix)

Oxervate (cenegermin)

Padcev (enfortumab vetodin)

Palynziq (pegvaliase)

Pemazyre (pemigatinib)

Perjeta (pertuzumab)

Phesgo (pertuzumab/trastuzumab/hyaluronidase)

Ponvory (ponesimod)

Pronextica (alpha1-proteinase inhibitor)

Quillivant (methylphenidate HCL)

Rylaze (crisantaspase)

Sarclisa (isatuximab-irfc)

Sohonos (palovarotene)

Spevigo (spesolimab)

Spravato (esketamine)

Sunlenca (lenacapavir)

Tabrecta (capmatinib)

Talvey (talquetamab)

Talzenna (talazoparib)

Tavneos (avacopan)

Tecartus (brexucabtagene autoleucel)

Tecentriq (atezolizumab)

Tecvayli (teclistamab)

Truqap (capivasertib)

Truseltiq (infigratinib)

Uplizna (inebilizumab)

Verquvo (vericiguat)

Vyvgart (efgartigimod alfa)

Welireg (belzutifan)

Yervoy (ipilimumab)

Yondelis (trabectedin)

4 steps of the process

  1. Information

    Call us at 1-844-410-6485 Phone number of Desjardins Insurance. This link opens your phone app. to find out what documents you need.

  2. Documentation

    Select the drug you've been prescribed from the list. Then download and complete the form. Note that the patient support program section is for group insurance claims only.

    Ask your doctor to complete the Attending physician section. Then send the form through our secure site or by mail (address listed on the form).

    Good to know

    You're responsible for any fees your doctor charges to complete the medical statement.

  3. Analysis

    Once we receive the required documents, we review your claim. Then we contact you to let you know if your claim is approved.

  4. Payment

    If your request is approved, you're reimbursed for the drug, in accordance with the terms of your policy.

How long does it take to process a prior authorization request?

If the form is completed correctly, it takes 5 business days to process once we get it.

Drug prior authorization forms

Select the form for the drug you've been prescribed and follow the instructions.

Your drug isn't on the list?

If your doctor said the drug requires prior authorization but it's not listed, fill out the general prior authorization request form.

Request prior authorization for a drug

By phone

Monday to Friday: 8 AM to 7 PM (Eastern Time)

1-844-410-6485 Phone number of Desjardins Insurance. This link opens your phone app.

Life insurance and living benefits products are manufactured by Desjardins Financial Security Life Assurance Company.