[Meta] the province rule is doing its job and people should stop complaining
Putting this to the board: the province rule is doing its job and people should stop complaining.
The pharmacist sorted in five minutes what the phone line had not managed in a fortnight.
Spent three weeks on what turned out to be a quantity limit rather than a coverage question.
Moved provinces and the coverage position changed completely. Same person, same history, different formulary.
Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.
best — the order this archive was captured in
Quantity limits restrict how much may be dispensed in a period even where coverage exists. They are a distinct barrier and require a distinct request.
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.
Have you asked the pharmacist to check?
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.
employer plans have their own criteria and their own appeals
employer plans have their own criteria and their own appeals
Agreed — write the application against the published criteria rather than around them.
Has your plan renewed since the last time you applied?
- 1Special authorization is a documented exception process with published…6 comments in this branch · started by u/mei_cardoso