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c/glp1canada·submitted 1 year ago by u/milos_vestergaard

[Question] special authorization — what am I missing here

Questionbranch of 6 comments

Asking properly rather than in a comment on somebody else’s thread: special authorization — what am I missing here. The pharmacist sorted in five minutes what the phone line had not managed in a fortnight. Kept every form and reference number. When they had no record of a submission, I did. Criteria changed at plan…

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6 comments, started 1 year ago
u/karim_restrepo265 points·1 year ago

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.

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u/zeynep_ndiaye62 points·1 year ago

Quantity limits restrict how much may be dispensed in a period even where coverage exists.

karim_restrepo is right that a rejected claim and a denied authorization are different animals.

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u/jarno_karlsen49 points·1 year ago

employer plans have their own criteria and their own appeals

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u/enzo_ferrari40 points·1 year ago

a rejected claim is not the same as a denied authorization

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u/aurel_lindqvist-34 points·1 year ago

Provincial plan, employer plan, or paying cash?

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u/gradient_goblin51 points·1 year ago

Confused a rejected claim with a denied authorization for a month and pursued entirely the wrong process.

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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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