Form HLTH5391 Special Authority Request - Dabigatran / Rivaroxaban for Atrial Fibrillation - British Columbia, Canada

Form HLTH5391 Special Authority Request - Dabigatran/Rivaroxaban for Atrial Fibrillation is used in British Columbia, Canada for requesting special authority to access and receive the medications Dabigatran or Rivaroxaban specifically for the treatment of Atrial Fibrillation.

The Special Authority Request Form HLTH5391 for Dabigatran/Rivaroxaban for Atrial Fibrillation in British Columbia, Canada, is typically filed by the prescribing healthcare provider or physician.

FAQ

Q: What is a Special Authority Request?
A: A Special Authority Request is a form used in British Columbia, Canada to request coverage for specific medications.

Q: What is Dabigatran and Rivaroxaban?
A: Dabigatran and Rivaroxaban are medications used to reduce the risk of stroke and blood clots in patients with atrial fibrillation.

Q: Who can use this form?
A: This form is for residents of British Columbia, Canada who have been prescribed Dabigatran or Rivaroxaban for atrial fibrillation.

Q: How do I submit a Special Authority Request?
A: The Special Authority Request form should be completed by your healthcare provider and submitted to the appropriate authority.

Q: What information is required on the form?
A: The form requires information about the patient, their medical history, and the prescribed medication.

Q: Is there a fee for the Special Authority Request?
A: There is no fee for submitting a Special Authority Request.

Q: How long does it take to process the request?
A: The processing time for a Special Authority Request can vary, but it is typically within a few weeks.

Q: Will I be notified of the decision?
A: Yes, you will receive a letter notifying you of the decision regarding your Special Authority Request.

Q: What happens if my request is approved?
A: If your request is approved, the requested medication will be covered by the health insurance program in British Columbia.

Q: What happens if my request is denied?
A: If your request is denied, you may have options for appealing the decision or pursuing other medication options with your healthcare provider.