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This version of the form is not currently in use and is provided for reference only. Download this version of
Form HLTH5826
for the current year.
Form HLTH5826 Special Authority Request - Empagliflozin / Semaglutide for Diabetes - British Columbia, Canada
Form HLTH5826 Special Authority Request - Empagliflozin/Semaglutide for Diabetes in British Columbia, Canada is used to request special authorization for the use of Empagliflozin/Semaglutide medication for the treatment of diabetes. This form is required to obtain coverage for this medication under the provincial drug benefit program.
It would be best to contact the Ministry of Health in British Columbia, Canada for information on who files Form HLTH5826.
FAQ
Q: What is a Special Authority Request?
A: A Special Authority Request is a formal application for coverage of a specific medication or treatment that may not be covered under the regular provincial drug plan.
Q: What is Empagliflozin/Semaglutide used for?
A: Empagliflozin/Semaglutide is used for the treatment of diabetes.
Q: Why would I need to submit a Special Authority Request for Empagliflozin/Semaglutide?
A: You would need to submit a Special Authority Request for Empagliflozin/Semaglutide if it is not already covered under the regular provincial drug plan.
Q: Who can submit a Special Authority Request?
A: A healthcare professional, such as your doctor or nurse practitioner, can submit a Special Authority Request on your behalf.
Q: How do I submit a Special Authority Request for Empagliflozin/Semaglutide?
A: Your healthcare professional will need to complete and submit the Special Authority Request form, including all required supporting documentation.
Q: How long does it take to process a Special Authority Request?
A: The processing time for a Special Authority Request can vary, but it is typically a few weeks.
Q: What happens after the Special Authority Request is approved?
A: If your Special Authority Request for Empagliflozin/Semaglutide is approved, you will receive coverage for the medication.
Q: What happens if the Special Authority Request is denied?
A: If your Special Authority Request is denied, you may have other options for obtaining coverage or financial assistance, such as patient assistance programs or private insurance.
Q: Can I appeal a denied Special Authority Request?
A: Yes, you can appeal a denied Special Authority Request. The process for appeals may vary, so it's best to consult with your healthcare professional or the relevant authorities for guidance.
Q: Is Empagliflozin/Semaglutide available in all provinces of Canada?
A: The availability of Empagliflozin/Semaglutide may vary by province. It is best to check with your local healthcare authority or pharmacist for specific information regarding availability and coverage.
