Quantity Limits

Certain  prescription medications have specific dispensing limitations for quantity and maximum dose. These dispensing limitations are based on generally accepted guidelines, drug label information approved by the Food and Drug Administration (FDA), current medical literature and input from a committee of physicians and pharmacists. The three types of quantity limits include the following:

• Coverage limited to one dose per day for drugs that are approved for once daily dosing
• Coverage limited to specific number of units over a defined time frame
• Coverage limited to approved  maximum daily dosage

How can I request an exception for a drug on the Quantity Limit list?

Your physician may request prior-authorization for quantity greater than set limit by completing the Prior Authorization Form and faxing it to the number listed on the top of the form. You can download a copy of this form and take it to your physician for completion.
Quantity Limit exception requests requests are generally processed within two business days of receipt of a completed Prior-Authorization form. EHP will notify your physician of request approval or denial by fax and to you by mail.

This list is subject to change without notice and is not applicable to all EHP groups. Consult your Summary Plan Description (SPD) to determine if your plan is subject to this list.