Drug prior authorization
Need to get prior authorization for a drug? We're here to help.
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
Alhemo (concizumab)
Amvuttra (vutrisiran)
Avastin (bevacizumab) and biosimilars
Ayvakyt (avapritinib)
Balversa (edafitinib)
Berinert (C1 esterase inhibitor)
Besponsa (inotuzumab ozogamicin)
Beqvez (fidanacogene elaparvovec)
Breyanzi (lisocabtagene maraleucel)
Brineura (cerliponase alfa)
Bylvay (odevixibat)
Cablivi (caplacizumab)
Casgevy (exagamglogene autotemcel)
Cerdelga (eliglustat)
Dacogen (decitabine)
Darzalex (daratumumab)
Demylocan (décitabine)
Diacetylmorphine Hydrochloride (diamorphine HCL)
Ebglyss (lebrikizumab)
Elrexfio (elranatamab)
Enhertu (trastuzumab deruxtecan)
Epidiolex (cannabidiol)
Epkinly (epcoritamab)
Eylea HD (aflibercept)
Finlius (ustekinumab)
Fruzaqla (fruquintinib)
Gavreto (pralsetinib)
Haegarda (C1 esterase inhibitor)
Hemgenix (etranacogene dezaparvovec)
Herceptin (trastuzumab) and biosimilars
Idhifa (enasidenib)
Imdelltra (tarlatamab)
Imfinzi (durvalumab)
Imjudo (tremelimumab)
Inqovi (decitabine-cedazuridine)
Jemperli (dostarlimab)
Keytruda (pembrolizumab)
Korsuva (difelikefalin)
Lartruvo (olaratumab)
Libtayo (cemiplimab-rwlc)
Litfulo (ritlecitinib)
Lumakras (sotorasib)
MDK-Nitisinone (nitisinone)
Miebo (perfluorohexyloctane)
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)
Tibsovo (ivosidenib)
Truqap (capivasertib)
Truseltiq (infigratinib)
Uplizna (inebilizumab)
Voranigo (vorasidenib)
Voydeya (danicopan)
Vyvgart (efgartigimod alfa)
Wainua (eplontersen sodium)
Winrevair (sotatercept)
Yervoy (ipilimumab)
Yondelis (trabectedin)
Zilbrysq (zilucoplan)
4 steps of the process
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.
Documentation
Select the drug you've been prescribed from the list. Then download and complete the form.
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.
Analysis
Once we receive the required documents, we review your claim. Then we contact you to let you know if your claim is approved.
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.
Speciality drugs that are part of the patient support program have an information and authorization section before the 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.
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