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Private Drug Coverage

If you are paying for any of your medications through private insurance, here is a helpful guide to ensure a smooth process.
Print and use this form while referring to the following guide:

Important Questions

IS THE MEDICATION COVERED BY MY PLAN?

Coverage will depend on your plan and the formulary of drugs they have decided to fund.

WHAT PERCENTAGE WILL MY PLAN COVER?

A typical amount covered is 80%. However, your coverage could be higher or lower depending on your plan. If you have less than 100% coverage and are in need of a very expensive drug, ask your cancer clinic pharmacy if there are any programs available to help pay the cost difference.

IS THERE AN ANNUAL FINANCIAL LIMIT OR CAP ON MY PLAN?

For expensive drugs, a limit can be reached quickly. It is important to know how long you will be on the drug to determine the overall cost.

IS THERE ANY "PRIOR AUTHORIZATION" NEEDED FOR THIS MEDICATION TO BE COVERED?

If you require prior or special authorization for your drug, a form can be printed from online and provided to your physician to complete. Ensure that you also sign it and include your personal information.

Dealing With a Denial From Your Insurer