Information for pharmacists and physicians

The Prescription Drug Program includes a number of features to help pharmacists and physicians better serve Veterans:

Point-of-service technology

Point-of-Service technology electronically links participating pharmacies and physicians to our adjudication system, letting them know almost instantly whether a Veteran qualifies for a particular pharmaceutical benefit.
The adjudication system also allows VAC to build custom formularies for individuals or for groups of veterans who may have unique or specific health care needs.

The Prescription Drug Program’s standard benefits are mainly common over-the-counter drugs or prescription medications. Most medications that authorized health professionals prescribe, or that pharmacists dispense, will be readily available to qualifying Veterans through our formulary. Less common medications or services may require special authorization.

Specialized medications or benefits require pre-authorization from VAC.
To request a pre-authorization, pharmacists or physicians must contact the Special Authorization Unit at 1-888-822-2884. This Unit is staffed by health care professionals from 7:00 a.m. to 8:30 p.m. (Atlantic time, Monday to Friday). Outside of regular hours, calls go to an answering service and will be followed up by a nurse the next business day.
In some instances, the Special Authorization Unit will need to confirm information with the Veteran’s doctor before issuing a pre-authorization. If a decision cannot be made within one hour, an interim approval may be granted for critical medications.

When a provider uses Point-of-Service technology to seek an approval for a Veteran, the index will quickly identify which drugs meet the qualification criteria established for that Veteran.
This index is based on the Anatomical Therapeutic Classification system.
The index links specific pharmaceuticals to medical pension codes established by VAC.
When the index cannot make a linkage, pharmacists are asked to call the Special Authorization Unit at 1-888-822-2884 to seek a manual decision.

For information on how to become an approved VAC provider, please contact Medavie Blue Cross.