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Instant Special Authority Confirmation

Pacific Blue Cross and BC PharmaCare have introduced new claims technology to instantly confirm benefit coverage for thousands of British Columbians with Special Authority approvals from BC PharmaCare. With the new technology, members will no longer be required to submit BC PharmaCare approval paperwork to Pacific Blue Cross, reducing wait times by up to a month.

Read the Benefits Canada interview with Leza Muir, Pacific Blue Cross Chief Operating Officer.

Pacific Blue Cross is the first insurance carrier to recognize real-time Special Authority confirmation. PharmaCare Special Authority grants full benefit status to a drug that otherwise would not be covered by PharmaCare. Patients who meet criteria pre-defined by PharmaCare are eligible.

“This move will immediately improve the health care experience for thousands of British Columbians,” says Jan K. Grude, President and CEO of Pacific Blue Cross. “We are delighted to partner with BC PharmaCare on this initiative and look forward to continued collaboration to keep health care coverage accessible and affordable for our 1.5 million members across the province.”

Annually, BC PharmaCare processes 250,000 Special Authority requests from physicians on behalf of their patients. In 2016, Pacific Blue Cross processed more than 14,000 Special Authority confirmations.

Drugs account for the highest share of claims costs paid by private benefit plans. Pacific Blue Cross drug plans are closely integrated with the BC PharmaCare formulary to facilitate utilization of PharmaCare coverage, which helps to lower benefit costs for group plan sponsors and their members.

Close to 50 per cent of BC pharmacies are currently enabled with real-time Special Authority confirmation technology, and the number is growing. Pacific BlueCross has updated its pharmacy lookup tool at to display pharmacies offering the service. British Columbians can also use the tool to compare prescription prices and dispensing fees to get the most value from their drug coverage.

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