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[Question] does the copay card stack with anything or is that a myth

Question Receipts ×9

Posting this because I searched for it and got nothing useful.

Setup: 7.5mg, week 84, sulphur burps present but not ruining anything. I changed exactly one variable — prior authorization — and tracked it for 6 weeks.

Result: a difference, but a small one, and well inside what I would call noise if someone else posted it. So I am putting it here rather than presenting it as a finding. If two or three other people have done the same thing we might actually learn something.

Not medical advice, obviously. This is one person with a spreadsheet.

864 up / 116 down88% upvoted59 commentsid 1dmg5917 Jul 2026

59 comments

24 in this archive, depth 5

best — the order this archive was captured in

u/hassan_chowdhury93 points·12 days ago

Titration speed is a side-effect dial far more than an efficacy dial.

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u/plain_titration55 points·11 days ago

Disagree but this is the good kind of wrong — it is specific enough to be checked.

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u/rekha_mbeki17 points·11 days ago

the carve-out clause varies by employer

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u/ferritin_low5 points·10 days ago

the carve-out clause varies by employer

Yes, exactly this, and it is the bit that took me 59 weeks to accept.

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u/tidy_vialdrawer_watch31 points·11 days ago

I am going to push back on this slightly.

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[deleted]12 points·10 days ago

[deleted]

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u/slow_logbook_notes10 points·10 days ago

do not suggest misrepresenting a diagnosis, that is fraud

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u/sofia_nascimento27 points·11 days ago

Which plan type? formulary is different.

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u/valeria_grimaldi19 points·11 days ago

formulary exclusions are negotiable sometimes

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u/rekha_mbeki9 points·11 days ago

Strongly agree. Step therapy is predictable if you have the criteria.

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u/honest_syringe1910 points·11 days ago

Small correction: the trial was 18 weeks, not 25. Does not change your point but people will quote it.

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u/kaia_cabrera6 points·10 days ago

Small correction: the trial was 18 weeks, not 25.

Adding to this: appeal is doing more work than the comment implies.

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u/honest_syringe19OP2 points·10 days ago

the carve-out clause varies by employer

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u/sanne_novak4 points·10 days ago

The confident tone is doing a lot of work that the evidence is not.

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u/honest_syringe19OP18 points·11 days ago·edited

copay is separate from coverage

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u/ahmed_abubakar-31 points·11 days ago

prior auth criteria are state-specific, copay differs

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u/elin_lindqvist1 point·10 days ago

This is correct. Appeal letters work.

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u/hugo_pires1 point·10 days ago

prior auth criteria are state-specific, copay differs

Disagree on that part. 98.7% and 98.9% on the same vial is normal.

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u/maren_ibarra12 points·11 days ago

This is correct. Appeal letters work.

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u/plain_titration_20244 points·10 days ago

Which plan type? external review is different.

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u/saskia_rahimi3 points·10 days ago

copay is separate from coverage

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u/oskar_kaufmann9 points·11 days ago

appeal letter templates are in the wiki

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u/marisol_moreau5 points·10 days ago

This is correct. Appeal letters work.

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u/gustav_vermeulen9 points·10 days ago

say which country and which plan type

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The paperwork war. Prior-authorisation criteria, denial reason codes, step-therapy documentation, external review, employer carve-outs, and the appeal letter templates the community has iterated on for three years. Mostly US-shaped but the tactics generalise.

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