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The Canada Life Assurance Company fax number
(833) 204-5809
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Drug Claims Management
Used for: Drug Prior Authorization submission for PSHCP medications
Fax destination details
- Department
- Drug Claims Management
- Purpose
- Drug Prior Authorization submission for PSHCP medications
- Form
- GLP-1 Prior Authorization Form — GLP-1 Prior Authorization Form (M6453)
- Address
- PO Box 6000, Winnipeg, MB R3C 3A5, Canada
- Voice phone
- 1-800-957-9777
- Website
- Visit organization website
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Form Completion Instructions: 1. Complete “Patient Information” sections. 2. Have the prescribing physician complete the “Physician Information” sections. 3. Send all pages of the completed form to us by mail, fax or email as noted below. Mail to: The Canada Life Assurance Company Drug Claims Management PO Box 6000 Winnipeg MB R3C 3A5; Fax to: The Canada Life Assurance Company Fax 1-833-204-5809 Attention: Drug Claims Management; Email to: CLPrior.Authorization@canadalife.com Attention: Drug Claims Management.
Official form instructions are published as a downloadable file on the organization's website.
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