Insured Health Services reconsideration request

Use this form to ask Insured Health Services to reconsider a coverage decision made through one of its benefit programs.

Submit the request within 20 business days of the date coverage was initially declined. Include any new or supporting information that may affect the original decision.

Follow the instructions on the form to submit the request. Do not send the completed form by regular email.

Learn more about the Yukon National Pharmacare Program.