Claims Requiring Pre-approvals

Prior Authorization Program (Extended Health Plan)

For medical services and equipment in excess of $5,000, a pre-authorization is required. Please refer to page 18 of the Policy Booklet (2017 edition).

Prior authorization requires that coverage for certain drug therapies be pre-approved based on certain criteria. For full details, refer to page 14-15 of the Policy Booklet (2017 edition).

You can also read about prior authorization on our website:

1. Go to hr.ubc.ca/rsb.
2. Scroll to find the header, “About RSB”.
3. Click on “Extended Health”.
4. Scroll to find “Reimbursement level for eligible expenses”.
5. Click on “Prior Authorization Program”.

Predetermination (Dental)

Before you receive treatment for any dental procedure(s) that costs more than $500, we recommend that you receive a predetermination from Sun Life. For full details, refer to page 32 of the Policy Booklet (2017 edition).

You can also access this information on our website:

1. Go to hr.ubc.ca/rsb.
2. Scroll to find the header “About RSB”.
3. Click on “Dental”.
4. Scroll to find “Dental care predetermination (over $500)”.

In our winter 2019 edition of Viewpoints, we will expand on these two topics. Look for the article in December.