how much of what we believe about formulary actually comes from private plan threads
how much of what we believe about formulary actually comes from private plan threads. I would rather ask a basic question now than get this wrong quietly for two months. Special authorization is a documented exception process with published criteria. Applications that answer those criteria explicitly, point by point,…
Pharmacy staff name removed. The pharmacy can stay in a pricing post.
Was this a denied authorization or a rejected claim?
ask the pharmacy what the cash price is, it varies
the same product can be covered in one province and not the next
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Disagree — that is your province’s formulary position and it does not carry to another.
Provincial plan, employer plan, or paying cash?
a denial letter names a criterion, that is your handle
Correction: that is regulatory approval, not coverage. They are separate decisions by separate bodies.
That is an employer plan process, and the provincial route is different in both form and timeline.