The maximum amount payable to an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category.

Immunization is covered for the following vaccines:

• Diphtheria, Tetanus, Pertusis, Haemagglutinin, Pertactin
• Measles, Mumps, Rubella Vaccine
• Varicella
• Hepatitis B
• TST (Tuberculin skin test)
• Meningococcal Vaccine Meningitis B
• H1N1, H3N2, Influenza

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 request exceptions.

Download and complete the Drug Exception Request Form to request coverage of a drug that is not automatically covered under the drug plan, 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 and provide the following information to access the portal: Carrier # 34, Group #: 166412.