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I’m worried that my expensive medications will not be covered. Will prior authorization of drugs be required?

May 1, 2024

Most drugs that are not “over the counter” are covered under the OSSTF Benefits Plan. Some drugs may require completion of a FACETs Authorization Form. NOTE: Completion of this form is not a guarantee of approval.

How to access the OTIP Drug Prior Authorization Program

If you or a family member covered under the OSSTF Benefits plan, need to seek approval for a specialty drug under the OSSTF ELHT Benefits Plan, simply follow the steps below:

  1. Log in to Health and Dental at www.otip.com.
  2. Under My Library, open the Resources tab.
  3. Click on the Drug Prior Authorization Form link.
  4. Click on Find my form.
  5. Select OSSTF Employee Life and Health Trust Benefits Plan.
  6. Search for the most applicable form based on your medication name.
  7. Fill out the form with your physician and send to FACET using the contact information outlined on the form.

The OTIP Drug Prior Authorization Program website can also be accessed directly by both members and physicians at pa.otip.com.

If you are unsure about whether a medication requires prior authorization, use the Drug Lookup Tool in My Claims to search for the name of your medication. The Drug Lookup Tool will provide details on whether the medication is immediately covered by your plan or if it requires prior authorization.

If all of the information required by the FACET team is provided, a decision about the coverage of a drug requiring prior authorization will be made within two business days. Where additional information may be required, a decision will be made within five business days 99% of the time.

Once the prior authorization decision has been made, you and your physician will be notified by the FACET team and provided with the specific rationale used to make the final decision.

More information about the program can be found in the FAQ section of the OTIP Prior Authorization Program website.

Access your medications more easily with Bayshore Pharmacy

Manulife, the insurer, has partnered with Bayshore Pharmacy Services to bring the Specialty Drug Care program (SDC) to OSSTF members. This program will help you manage your specialty medications by delivering them directly to you, providing a 24/7 pharmacy hotline, and phone support with a dedicated nurse.

Beginning September 1, 2020 all new and existing claimants starting a new specialty drug will be administered through the SDC program. This will ensure OSSTF members get access to their medications quickly and have access to the advice and support they need.

NOTE: If you are already receiving specialty drugs, you can continue to purchase as you have been. Or, if you would like to switch to the new program, please contact OTIP Benefits Services at 1-866-783-6847.


The information in this document is provided by OSSTF Benefits for general information only. OSSTF Benefits endeavours to have all information current and accurate. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, or suitability of the information included. All information is subject to change without notice.


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