[PSA] private plan is not what most of this community thinks it is
Putting this at the top of the board where it belongs: private plan is not what most of this community thinks it is. The three separate questions people ask here as though they were one. Is it approved for sale — a national regulatory question with one answer. Is it covered — a provincial or private-plan question…
Nothing here is medical or legal advice. The pharmacist and the prescriber are the people who can act, and both are faster than a forum.
Yes. Cash prices vary and comparing them before assuming coverage is the only route is worth doing.
keep every form, every date, every reference number
Agreed. Province first — coverage is a provincial decision and national answers are wrong somewhere by construction.
quantity limits are as common a barrier as coverage itself
formulary decisions are provincial, so the province is the first fact
special authorization forms are published, read them before applying
The pharmacist sorted in five minutes what the phone line had not managed in a fortnight.
Correction: that is regulatory approval, not coverage. They are separate decisions by separate bodies.
Compared cash prices across four pharmacies before pursuing coverage and the spread was larger than I expected.