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Sun life drug exception application form 2025

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The document is a Drug Exception Application Form from Sun Life Assurance Company of Canada, allowing plan members to request coverage for medications that are not fully covered or require more frequent dispensing than their plan allows. It outlines the eligibility criteria, necessary information for both the plan member and prescribing physician, and emphasizes that completion of the form does not guarantee approval. The document also includes privacy information and instructions for submission.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (138 Votes)
2014	4.4 Satisfied (221 Votes)
2013	4.4 Satisfied (23 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What happens when a medication is not on the formulary?

A non-formulary drug refers to any medication that isnt included on your health insurance plans formulary. These drugs are oftentimes not covered meaning that you will likely have to pay the full price unless you take steps to request coverage.

What is pharmacy exception processing?

The exception process can be used to override benefit limits that are based on U.S. Food and Drug Administration (FDA)-approved durations of treatment or maximum dosing limits. A plan may limit drug benefit coverage to FDA-approved durations or dosing.

What does formulary drug exclusion mean?

Formulary exclusions are drugs that a PBM chooses not to be included in coverage. Usually, a PBM will contract with multiple insurance providers to manage their prescription benefits. A provider can choose not to follow their PBMs formulary exclusion list if they wish to cover a drug.

What is the drug formulary exception process?

If you need a medication that is not on your plan list, you can formally ask your insurer to cover the medication for you by submitting a formulary exception. Once the exception is filed, the plan should provide a decision within 72 hours.

How long does it take for Sun Life to process a claim?

Claims submitted either through the my Sun Life mobile app or through the web are usually settled promptly. If approved, any reimbursement amount is usually deposited into your bank account within 2 business days, if youre signed up for direct deposit.

sun life drug coverage list

Sunlife drug exception form pdf Sun Life prior Authorization form pdf Sun Life special Authorization form Sun Life special authorization form OZEMPIC Sun Life special authorization form wegovy Drug Exception form Canada Life List of drugs covered by sunlife pdf Request for drug exception form canada post

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What is a drug exception option?

In some cases, if your drug is in a higher tier and your prescriber thinks you need that drug instead of a similar drug in a lower tier, you or your prescriber can ask your plan for an exception to get a lower coinsurance or copayment for the drug in the higher tier. Plans can change their drug list at any time.

What is the waiver of premium in Sun Life?

Waiver of Premium is a provision that continues your Group Life premium payments if you become totally disabled. If you become totally disabled and your Waiver of Premium claim is approved by Sun Life, we will continue your Life insurance coverage without further payments from you or your employer.

What is the formulary exception process?

A formulary exception should be requested to obtain a Part D drug that is not included on a plan sponsors formulary, or to request to have a utilization management requirement waived (e.g., step therapy, prior authorization, quantity limit) for a formulary drug.

Sun life drug exception application form 2025

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What happens when a medication is not on the formulary?

What is pharmacy exception processing?

What does formulary drug exclusion mean?

What is the drug formulary exception process?

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What is a drug exception option?

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sun life prior authorization form pdf

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