[Question] how do you actually verify special authorization
how do you actually verify special authorization. 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 completely. Same person, same history, different formulary.
Spent three weeks on what turned out to be a quantity limit rather than a coverage question.
Sceptical readings welcome. The confident ones are the ones I distrust.
best — the order this archive was captured in
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.
quantity limits are as common a barrier as coverage itself
quantity limits are as common a barrier as coverage itself
This is why every thread here needs a province in it.
Yes. Cash prices vary and comparing them before assuming coverage is the only route is worth doing.
the criteria change at plan renewal and nobody announces it
Right, and the pharmacist can usually give a definite answer faster than a week of forum speculation.
quantity limits are as common a barrier as coverage itself
Adding the fastest step — ask the pharmacist. They can usually check in minutes.
Careful, that criterion was updated at renewal and the version you are quoting is superseded.
Small fix — that formulary position is another province’s and does not apply here.
the pharmacist is often the fastest route to a definite answer
Agreed on keeping every form and date. When something goes wrong the paper trail is the whole case.
compare cash prices before assuming coverage is the only path
Formulary criteria are revised, and plan renewal is a natural point at which a previously refused request may succeed without anything about the applicant changing.
- 1Nothing here is medical or legal advice. The pharmacist and the prescriber…7 comments in this branch · started by u/spreadsheet_gremlin