March 1, 2023
To: Urban/RSMC’s members,
Updated January 1, 2023
Plan(s) it applies to:
- Extended health Care Plan
You use it to:
Use this form to request coverage of a drug that is not automatically covered under your drug plan. Provide the requested information to ensure timely assessment of your claim.
* Please click on the following link to view this revised list of prescriptions and the associated drug exception form for submission to Canada Life Assurance Company.