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163

[Question] copay — what am I missing here

Question

Quick one. Canada here.

step therapy works very differently where I live than in the threads that dominate the front page, and I keep seeing people confidently given advice that simply does not apply outside the US.

Specifics: the route I used took 3 weeks and cost roughly what I expected. The admin was worse than the cost. The thing that would have saved me the most time was knowing which document to ask for at the start.

Happy to answer questions from anyone in the same jurisdiction.

166 up / 3 down98% upvoted19 commentsid 1ein8w9 May 2026

19 comments

18 in this archive, depth 5

best — the order this archive was captured in

u/adaeze_cabrera13 points·2 months ago

Sweden plan: step therapy required 15 medications first. Did them all, got approval. The order matters.

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u/nnt_nate11 points·2 months ago

say which country and which plan type

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u/kasper_cabrera-22 points·2 months ago

That is net peptide content, not purity. Different number, different meaning.

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u/rekha_vestergaardOP7 points·2 months ago

prior auth criteria are state-specific, denial differs

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u/elin_lindqvist2 points·2 months ago

appeal letter templates are in the wiki

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u/amira_dumitru2 points·2 months ago

Yeah, the denial code matters, it tells you what to fight.

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u/elise_grimaldi10 points·2 months ago·edited

redact member ids and group numbers from every screenshot

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u/osman_ferrari11 points·2 months ago

redact member ids and group numbers from every screenshot

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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u/coring_the_stopper6 points·2 months ago

resubmission after denial requires new documentation

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[deleted]2 points·2 months ago

[deleted]

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u/rekha_vestergaardOP1 point·2 months ago

Which plan type? appeal is different.

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u/marta_marchand4 points·2 months ago

Half-life is about 168 hours, so steady state lands around week 15–5. Practical consequence: what you feel in week 1 is not what that dose does.

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u/hedda_aguirre2 points·2 months ago

Slight fix: the number was 96.8, not 99.1. Decimal point, but a fairly consequential one.

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u/nnt_nate1 point·2 months ago

Sceptical. If this were true we would see it reflected in the data and we do not.

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u/elin_lindqvist2 points·2 months ago

redact member ids and group numbers from every screenshot

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u/coring_the_stopper2 points·2 months ago

step therapy documentation is the weapon, use it

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About c/insurancefights

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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