What is Special Authority?
A Special Authority grants full benefit status to a medication that would otherwise be a partial benefit or a limited coverage drug. Actual coverage is based on the patient's eligibility and deductible criteria.
Certain drugs may require a Special Authority before PharmaCare will cover them. For details on which drugs do require Special Authority, click on the links to drug categories listed in the right-hand column of this page.
Coverage is based on the Low Cost Alternative Drug Program, Maximum Days' Supply, and Maximum Pricing Policy.
Special Authorities are granted for a specific drug for an individual patient. In rare cases, however, a Special Authority exemption may be granted to a physician or physician specialty group. These exemptions provide coverage of specific drugs for all the patients of a physician or specialty group.
To find the generic drug name to determine eligibility for Special Authorities, click here.
To simplify ongoing approvals, PharmaCare introduced Assumed Special Authorities.
Special Authority Process Overview (PDF 6Kb)