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:

• dTap (Diptheria, Tetanus, Pertussis)
• MMR (Measles-Mumps-Rubella)
• Varicella
• Hepatitis B
• TST (Tuberculin skin test)
• Meningitis B

To obtain bloodwork to confirm previous immunizations you can use myvirtualdoctor for your bloodwork requisition. Once your bloodwork is confirmed, you can also use myvirtualdoctor to obtain prescriptions for your immunizations.

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 #: 157921.