Blue RX Limited Benefit Drugs

Certain higher cost or second line drugs require pre-approval before they can be covered under your Blue RX® plan. Depending on the drug, approval may be required either by Pacific Blue Cross or by the BC PharmaCare Special Authority program.

Drugs requiring PBC Prior Approval: forms can be found by selecting the appropriate tab below. Click on the hyperlink beside the drug name to download the appropriate form. Please have your doctor complete the appropriate form and send it to Pacific Blue Cross to determine eligibility.

NOTE: For some drugs, if the prescribing doctor is a specialist in that therapeutic area (e.g. respirologists for asthma), they don’t have to fill out the form. However, you will need to complete the top portion of the form. Be sure to follow the instructions on the form carefully.

Drugs that require BC PharmaCare Approval: A complete list of drugs requiring BC PharmaCare Special Authority can be found by selecting the appropriate tab below and opening the pdf list provided under that tab.

Go to pharmacycompass.ca to find your nearest pharmacy offering real-time Special Authority confirmation.

For more information, here's what you need to know about the Blue RX plan

Drugs that require Prior Approval

Trade/Brand Name   Chemical Name   Form  

Drugs Requiring BC PharmaCare Approval

Certain drugs require that your doctor apply to BC PharmaCare and be approved for Special Authority before they are eligible with your plan.

If your drug has not been approved

If for some reason coverage of your prescription has not been approved through Blue RX Prior Approval or through the BC PharmaCare Special Authority Program, use the Drug Eligibility Inquiry Form to trigger an inquiry about drug coverage eligibility under your plan.

Drug coverage can vary from plan to plan. Our Pharmacy Services division will review your coverage and the reasons behind denial of your claim to determine if there is any way the drug can be covered under the provisions of your Extended Health Care plan

 

Completion of the forms above does NOT imply approval for the drug. Coverage is based on the provisions of your Extended Health Care plan.