Government of Saskatchewan
Wednesday, December 13, 2017
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Form List Using "aid programs"

  A  |  D  |  E  |  M  |  P  |  R  |  S  |
 
A
  Aricept/Exelon/Reminyl Exception Drug Status Application - (for Physician Use Only)
(Health) Application form used by physicians to request drug coverage for Aricept or Exelon on behalf of their patients.
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D
  Direct Deposit Payment Request Form - (for Pharmacy Use Only)
(Health) Form used by pharmacists to arrange direct payment for pharmacy claims.
  Drug Plan - Cancelled Claims Advisory - (for Pharmacy Use Only)
(Health) Allows pharmacies to cancel claims already adjudicated electronically but cannot be reversed electronically.
  Drug Plan - Certificate Authorization Form
(Health) Pharmacists must complete form to receive certificates for security purposes. The certificates ensure that only pharmacies access the drug plan data base.
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E
  Exception Drug Status Application for Ankylosing Spondylitis Drugs - (for Rheumatologist Use Only)
(Health) Application form used by Rheumatologists to request Exception drug status coverge for drugs used to treat Ankylosing Spondylitis on behalf of their patients/ clients.
  Exception Drug Status Request Form - (for Pharmacy or Physician Use Only)
(Health) Application form used by physicians and pharmacists to request Exception drug status coverage on behalf of their patients/ clients.
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M
  MS Drugs Exception Status Application - (for Physician Use Only)
(Health) Application form used by physicians to request coverage (on behalf of their patients) for drugs used in treatment of multiple sclerosis, specifically Betaseron/Copaxone/Rebif/Avonex-form is submitted to the MS Drug Advisory Panel for review.
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P
  Pharmacy Claim - In Province - (for Pharmacy Use Only)
(Health) Manual billing of prescription claims from community pharmacies located in Saskatchewan. These pharmacies submit the claim for payment if the claim is not electronically adjudicated on the Drug Plan network. Some reasons may be because of quantity restrictions or a change in coverage.
  Pharmacy Claim - Out of Province - (for Pharmacy Use Only)
(Health) Manual billing of prescription claims from out patient hospital pharmacies located outside of Saskatchewan. These pharmacies submit the claim so patients receiving treatment outside of the province don't pay costs or pay as they would if in Saskatchewan
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R
  Request for Palliative Care Coverage - (for Physician Use Only)
(Health) Application form completed by physicians on behalf of their patients to request Palliative Care drug coverage under the Drug Plan.
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S
  Special Support Program - Drug Plan - Side B - Annual Application
(Health) This form is used to request income information for assessment of eligibility for those with high drug costs in relation to income. You must complete this form and submit it with your income information each year. If you prefer to submit a one-time form that authorizes the Drug Plan to obtain your income tax information from Canada Revenue Agency (CRA), please use the CRA Application/Consent Form SIDE A).
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