The maximum amount payable to an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category. Dispensing fees are not covered.

• Hepatitis B vaccines has been added to the policy on an exception basis.
• The cost of Concerta is covered, up to the cost of the generic substitute with the lowest price only.

Drug Exception Process

If the medications covered by your insurance do not work for your condition, or if an effective drug is not covered, there is a special process to handle exceptions.

Download the form and print it, ask your doctor to complete the physician information section and submit your request to be considered for a drug exception.

To be considered for a drug exception, you must have tried at least one medication on your student health plan.

Prior-Authorization Drug Claims

Some prescription drugs require prior authorization before reimbursement is considered. You must submit a form to get prior authorization. Once prior authorization has been confirmed by the prescription search tool, you must complete this form with your doctor and submit it. Find a Prior Authorization Form