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c/glp1canada·submitted 7 months ago by u/draw_up_dizzy

genuine question about private plan that I am slightly embarrassed to ask

Questionbranch of 7 comments

genuine question about private plan that I am slightly embarrassed to ask. If this has been answered properly somewhere, link me and I will delete. Compared cash prices across four pharmacies before pursuing coverage and the spread was larger than I expected. Moved provinces and the coverage position changed…

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7 comments, started 7 months ago
u/anya_antonsen63 points·7 months ago

Special authorization is a documented exception process with published criteria. Applications that answer those criteria explicitly, point by point, fare better than general clinical narratives.

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[deleted]45 points·7 months ago

[deleted]

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u/draw_up_dizzyOP33 points·7 months ago

Provincial plan, employer plan, or paying cash?

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u/isabela_guerrero9 points·7 months ago

Small fix — that formulary position is another province’s and does not apply here.

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u/draw_up_dizzyOP13 points·7 months ago

Have you asked the pharmacist to check?

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u/draw_up_dizzyOP5 points·7 months ago

Correcting myself: it was a quantity limit rather than a denial, which changes the whole process.

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u/the_poster_in_question_202651 points·7 months ago

Health Canada approval is not coverage

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Canadian access: provincial formulary differences, private plan coverage, the special-authorisation process, cross-border pricing arbitrage and why the Ontario answer is not the Alberta answer.

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