Drug prior authorization

Need to get prior authorization for a drug? We're here to help.

1-844-410-6485 Phone number of Desjardins Insurance. This link opens your phone app.

Before you get started

Important

Drugs for the treatment of obesity

Some drugs used to treat obesity might not be covered by your insurance plan:

Contrave (naltrexon/bupropion) (PDF, 1.85 MB)

Saxenda (liraglutide) (PDF, 1.85 MB)

Wegovy (semaglutide) (PDF, 1.85 MB)

Xenical (orlistat) (PDF, 1.85 MB)

Read your insurance booklet to see if you're eligible. If your plan covers these drugs, send us the form once it’s been completed by you and your physician.

Understand your drug coverage

Drug coverage can vary depending on your plan or home province. Also, some drugs are excluded from our plans or require prior authorization.

Read our prior authorization drugs pamphlet (PDF, 606 KB)

If you're covered by a provincial health plan, submit your claim to that plan first as it may cover the drug. If your claim is denied, submit a copy of the denial with our request form.

See excluded drugs and products

We do not reimburse the drugs and products listed below. Note that the list may be changed without notice and certain plans may exclude other drugs that are not on the list.

For more information, see your insurance booklet.

Excluded drugs and products

Alhemo (concizumab)

Amvuttra (vutrisiran)

Avastin (bevacizumab) and biosimilars

Ayvakyt (avapritinib)

Balversa (edafitinib)

Berinert (C1 esterase inhibitor)

Besponsa (inotuzumab ozogamicin)

Beqvez (fidanacogene elaparvovec)

Brineura (cerliponase alfa)

Bylvay (odevixibat)

Cablivi (caplacizumab)

Cerdelga (eliglustat)

Dacogen (decitabine)

Darzalex (daratumumab)

Demylocan (décitabine)

Diacetylmorphine Hydrochloride (diamorphine HCL)

Elrexfio (elranatamab)

Eylea HD (aflibercept)

Enhertu (trastuzumab deruxtecan)

Epidiolex (cannabidiol)

Epkinly (epcoritamab)

Finlius (ustekinumab)

Fruzaqla (fruquintinib)

Gavreto (pralsetinib)

Haegarda (C1 esterase inhibitor)

Hemgenix (etranacogene dezaparvovec)

Herceptin (trastuzumab) and biosimilars

Idhifa (enasidenib)

Imfinzi (durvalumab)

Imjudo (tremelimumab)

Inqovi (decitabine-cedazuridine)

Jemperli (dostarlimab)

Keytruda (pembrolizumab)

Korsuva (difelikefalin)

Koselugo(selumetinib)

Lartruvo (olaratumab)

Libtayo (cemiplimab-rwlc)

Livmarli (maralixibat)

Litfulo (ritlecitinib)

Lumakras (sotorasib)

MDK-Nitisinone (nitisinone)

Miebo (perfluorohexyloctane)

Minjuvi (tafasitamab)

Mounjaro (tirzepatide)

Myalepta (metreleptin)

Nerlynx (neratinib)

Nexviazyme (avalglucosidase alfa)

Nitisinone (nitisinone)

Opdivo (nivolumab)

Optune device

Orfadin (nitisinone)

Orladeyo (berotralstat)

Orgovyx (relugolix)

Oxervate (cenegermin)

Padcev (enfortumab vetodin)

Palynziq (pegvaliase)

Pemazyre (pemigatinib)

Perjeta (pertuzumab)

Phesgo (pertuzumab/trastuzumab/hyaluronidase)

Ponvory (ponesimod)

Pronextica (alpha1-proteinase inhibitor)

Quillivant (methylphenidate HCL)

Rylaze (crisantaspase)

Sarclisa (isatuximab-irfc)

Sohonos (palovarotene)

Spevigo (spesolimab)

Spravato (esketamine)

Sunlenca (lenacapavir)

Tabrecta (capmatinib)

Talvey (talquetamab)

Talzenna (talazoparib)

Tavneos (avacopan)

Tecartus (brexucabtagene autoleucel)

Tecentriq (atezolizumab)

Tecvayli (teclistamab)

Tibsovo (ivosidenib)

Truqap (capivasertib)

Truseltiq (infigratinib)

Uplizna (inebilizumab)

Voranigo (vorasidenib)

Voydeya (danicopan)

Vyvgart (efgartigimod alfa)

Winrevair (sotatercept)

Yervoy (ipilimumab)

Yondelis (trabectedin)

Zilbrysq (zilucoplan)

4 steps of the process

Information

Call us at 1-844-410-6485 Phone number of Desjardins Insurance. This link opens your phone app. to find out what documents you need.
Documentation

Select the drug you've been prescribed from the list. Then download and complete the form.

Ask your doctor to complete the Attending physician section. Then send the form through our secure site or by mail (address listed on the form).

Good to know

You're responsible for any fees your doctor charges to complete the medical statement.
Analysis

Once we receive the required documents, we review your claim. Then we contact you to let you know if your claim is approved.
Payment

If your request is approved, you're reimbursed for the drug, in accordance with the terms of your policy.

How long does it take to process a prior authorization request?

If the form is completed correctly, it takes 5 business days to process once we get it.