Drugs Requiring Preauthorization

The following drugs require preauthorization and/or are subject to quantity limitations. Preauthorization is performed by Encompass Health Management Systems on behalf of American Republic.

Preauthorization is not a guarantee of benefits. Payment of benefits will be determined by the terms and limits of your insurance coverage.

• accutane
• Actiq
• Amevive
• Amnesteem
• Arava
• Avonex
• Betaseron
• Botox Injection
• Cimzia
• Claravis
• Copaxone
• Copegus
• Enbrel
• Forteo
• Fuzeon
• Growth Hormones (Most policies have a contract limitation of $10,000 per lifetime.)
  • Genotropin
  • Geref
  • Humotropin
  • Norditropin
  • Nutropin
  • Nutropin AQ
  • Nutropin Depot
  • Protropin
  • Saizen
  • Somatropin
  • Serostim
• Humira
• Infergen
• Intron-A
• Kineret
• Lamisil
• Myobloc
• Novantrone
• Orencia
• Peg-Intron
• Pegasys
• Raptiva
• Rebetol
• Rebetron
• Rebif
• Remicade
• Revatio
• Rituxan
• Roferon-A
• Sotret
• Spiriva
• Sporonox
• Tazorac
• Topamax
• Tysbri
• Xolair
• Zavesca
• Zonegran

• Stadol NS
• Toradol